May 8th

1011 MCQS
Питання №: 1
Hyperpigmentation of skin occurs in :
Addison's disease
Haemochromatosis
Cushing's disease
Haemosiderosis
Which of the following is characterized by normotension, hypokalemia, and
metabolic alkalosis?
Barrter’s syndrome
Hyperaldosteronism
Liddle’s syndrome
Sjögren’s syndrome
Entrapment of the median nerve causing carpal tunnel syndrome and if severe,
muscle wasting in the thenar eminence of the hand, is associated with which of
the following diseases?
All of the above
Diabetes
Amyloidosis
Rheumatoid arthritis
Hypothyroidism
A patient with constant headaches, pain in the occipital region, tinnitus,
dizziness has been admitted to the cardiology department. Objectively: AP (BP)
- 180/110mm Hg, heart rate - 95/min. Radiographically, there is a stenosis of
one of the renal arteries. Hypertensive condition in this patient has been caused
by the activation of the following system:
Renin-angiotensin
Hemostatic

Sympathoadrenal
Kinin
Immune
For biochemical diagnostics of myocardial infarction it is necessary to measure
activity of a number of enzymes and their isoenzymes. What enzymatic test is
considered to be the best to prove or disprove the diagnosis of infarction in the
early period after the chest pain is detected?
Creatine kinase isoenzyme CK-MB
Creatine kinase isoenzyme CK-MM
LDH1 lactate dehydrogenase isoenzyme
LDH2 lactate dehydrogenase isoenzyme
Aspartate aminotransferase cytoplasmic isoenzyme
A 56-year-old man presents with complaints of gnawing pain in the mid-
epigastrium, with occasional radiation to the back. He also notes a IS-pound
weight loss over the past 3 months. The clinician suspects pancreatic
carcinoma. Which of the following tumor markers would aid in confirming this
diagnosis?
Carcinoembryonic antigen (CEA)
CA-125
Alpha-fetoprotein (AFP)
Human chorionic gonadotropin (hCG)
Prostate-specific antigen (PSA)
Processes of repolarisation are disturbed in ventricular myocardium in examined
person. It will cause amplitude abnormalities of configuration and duration of
the wave:
Т
P
Q
S

R
A 58-year-old woman complaints of increased tiredness, decreased capacity for
work, somnolence and dyspnea during fast walking. Blood test revealed:
erythrocytes - 4,6*1012/l, hemoglobin - 92 g/l, color index - 0,6. Blood smear
demonstrated high contents of microcytes and anulocytes. What anemia is it
typical for?
Iron deficiency
Hemolytic
Acute posthemorrhagic
Pernicious
Sickle cell
A 21-year-old college student and varsity football player comes to the
emergency room with complaints of nausea, fatigue, mild right upper quadrant
pain, and anorexia of several days. He has been at practice with the football
team this spring and summer at a substitute practice field near the campus and
he drank from a faucet of cold water at the edge of the field and near a farm.
He does not use drugs. He drinks an occasional beer. Two other team members
were examined recently for similar symptoms. On examination, his liver is
minimally enlarged and tender. His serum bilirubin is 2.5 mg/dL and his AST
and ALT are elevated. Which disease is he likely to have?
Hepatitis due to HAV
Wilson’s disease
Cirrhosis
Hepatitis due to HBV
Hepatitis due to HCV
An elderly woman is seen at your office with a complaint of loss of vision in her
left eye, which had been transient on a couple of occasions but is now
persisting. She has been seen recently at urgent care centers for multiple
complaints including generalized fatigue, left-sided dull boring headaches with
occasional sharp jabbing sensations, and arthritic complaint in the hips. In
addition, she reports some recent loss of 7 to 10 pounds. The only remarkable

finding on the routine labs obtained from her prior evaluations is an elevated
alkaline phosphatase. You determine that the likely cause of her condition is?
Temporal arteritis
Brain tumor arising anterior to the optic chiasm
Optic neuritis
Glaucoma
The pattern of normal TSH, normal T4, and low T3 is most consistent with:
Nonthyroidal illness (sick euthyroidism)
Hyperthyroidism
Estrogen therapy
Subclinical hypothyroidism
Familial (euthyroid) dysalbuminenic hyperthyroxinemia
Patients commonly complain of “dizziness.” This symptom is?
A loosely defined and nonspecific symptom of light-headedness or weakness or
spinning
Usually accompanied by the physical finding of nystagmus
Usually accompanied by hearing loss
A well-defined sensation of one’s environment spinning around
A specific sign of impending stroke
Person has stable HR, not more than 40 bpm. What is the pacemaker of the
heart rhythm in this person?
Atrioventricular node
Branches of His' bundle
Purkinje fibers
His' bundle
Sinoatrial node

A patient with respiratory failure has blood pH of 7,35. pCO2 test revealed
hypercapnia. Urine pH test revealed an increase in the urine acidity. What form
of acid-base imbalance is the case?
Compensated respiratory acidosis
Compensated metabolic acidosis
Decompensated metabolic acidosis
Compensated respiratory alkalosis
Decompensated respiratory alkalosis
A 55-year-old man, who has a 50-pack-year history of smoking cigarettes has a
moon face, truncal obesity with purple stria, and thin extremities. Which of the
following sites is the primary tumor most likely located to produce these
findings?
Lung
Liver
Kidney
Testicle
Thyroid
Which of the following haemoglobinopathies is characterized by increased
affinity for oxygen:
β-thalassaemia
Hb Chesapeake
HbS
Hb-M Boston
Pancytopenia is associated with :
Paroxysmal nocturnal hemoglobinuria
Paroxysmal cold hemoglobulinuria
Thalassemia
Hereditary spherocytosis

Fatigue, anorexia, orange/brown-colored urine, and an ALT level greater than
10 times normal are clinical features of?
Any viral hepatitis
Hepatitis A
Hepatoma
Hepatitis B and hepatitis C
Hepatitis B, but not hepatitis C
During regular check-up a child is detected with interrupted mineralization of
the bones. What vitamin deficiency can be the cause?
Calciferol
Riboflavin
Tocopherol
Folic acid
Cobalamin
Workers of a conveyor workshop received recommendations for the effective
organization of working time and higher working efficiency. What peculiarity of
work in this workshop causes the greatest stress for the workers?
Monotony of work
State of "operating rest"
Increased intellectual component
Increased responsibility
Social inefficiency of labor
During histological examination of the stomach it was found out that glands
contain very small amount of parietal cells or they are totally absent. Mucous
membrane of what part of the stomach was studied?
Pyloric part
Body of stomach

Cardiac part
Fundus of stomach
-
By the decarboxylation of glutamate in the CNS an inhibitory mediator is
formed. Name it:
GABA
Glutathione
Histamine
Serotonin
Asparagine
The most common cause of portal hypertension is?
Cirrhosis
Hepatic venoocclusive disease
Noncirrhotic portal fibrosis
Portal vein obstruction
Hepatic vein thrombosis
The most sensitive indicator of infection with hepatitis C virus (HCV) is?
HCV RNA
Anti-HCV, second-generation assay against C200 and C22-3
Anti-HCV, third-generation assay against C200, C22-3, and NS5
Antienvelope proteins E2/NS1
Anti-HCV, first-generation assay against C100-3
Patients arrived to emergency care unit with shortness of breath, chest pain and
sweating. From his anamnesis known that he suffer from with cardial septal
defect and deep vein thrombosis. Doctor put diagnosis paradoxical embolism,
what means:

When an embolus arises in a vein but lodges in an artery
Embolism with amniotic fluid
Embolism with fat
Embolism with air
Gas embolism
The dangerous complication in the second week of massive myocardial
infarction is:
Rupture of the heart
Congestive heart failure
Bacterial endocarditis
Ventricular aneurysm
A patient has a transverse disruption of spinal cord below the IV thoracic
segment. What changes of respiration will it cause?
Respiration will stay unchanged
Respiration will become less frequent
Respiration will become more frequent
Respiration will become deeper
Respiration will stop
When studying the signs of pulmonary ventilation, reduction of forced
expiratory volume has been detected. What is the likely cause of this
phenomenon?
Obstructive pulmonary disease
Increase of respiratory volume
Increase of inspiratory reserve volume
Increase of pulmonary residual volume
Increase of functional residual lung capacity

Which cerebral artery is blocked in an ischemic stroke that presents with the
following symptoms: aphasia, right hemiparesis, and right arm numbness?
Left middle cerebral
Right middle cerebral
Right proximal posterior cerebral
Left anterior cerebral
Right anterior cerebral
The number of haemoglobin molecules per red blood cell are?
280 million
40 million
2 million
360 million
A patient has been diagnosed with Upper respiratory tract infection (URTI).
Blood serum contains immunoglobulin M. What stage of infection is it?
Acute
Prodromal
Incubation
Reconvalescence
Carriage
A patient has insufficient blood supply to the kidneys, which has caused the
development of pressor effect due to constriction of arterial resistance vessels.
This condition results from the vessels being strongly affected by the following
substance:
Angiotensin II
Angiotensinogen
Renin
Catecholamines

Norepinephrine
A 56 year old patient came to a hospital with complaints about general
weakness, tongue pain and burning, sensation of limb numbness. In the past he
underwent resection of fore stomach. In blood: Hb-80 g/l; erythrocytes -
2,0*1012/l; color index - 1,2, leukocytes - 3,5*109/l. What anemia type is it?
B12-folate deficient
Hemolytic
Aplastic
Iron-deficient
Posthemorrhagic
A 45 year old patient was admitted to the cardiological department. ECG data:
negative P wave overlaps QRS complex, diastolic interval is prolonged after
extrasystole. What type of extrasystole is it?
Atrioventricular
Atrial
Ventricular
Sinus
Bundle-branch
A hospital has admitetd a patient complaining of abdominal bloating, diarrhea,
flatulence after eating protein foods. These signs are indicative of the impaired
digestion of proteins and their increased degradation. Which of the following
compounds is the product of this process?
Indole
Bilirubin
Cadaverine
Agmatine
Putrescine

Haematuria, haemoptysis and proteinuria are seen in?
Good pasture’s syndrome
SLE
Infective endocarditis
Henoch Schonlein Purpura
A patient is diagnosed with cardiac infarction. Blood test for cardiospecific
enzymes activity was performed. Which of the enzymes has three isoforms?
Creatine kinase
Lactate dehydrogenase
Aspartate transaminase
Alanine transaminase
Pyruvate kinase
A patient with hypersecretion of the gastric juices was recommended to exclude
concentrated bouillons and vegetable decoctions from the diet because of their
stimulation of gastric secretion. What is dominating mechanism of stimulation of
secretion in this case?
Stimulation of gastrin production by G-cells
Irritation of taste receptors
Stimulation of excretion of secretin in the duodenum
Irritation of mechanoreceptors of the stomach
Irritation of mechanoreceptors of the oral cavity
In which ovarian compartment is transforming growth factor-α produced?
Theca
Granulosa
Follicular fluid
Follicles
Corpus luteum

Spasm of smooth muscle of bronchi developed in the patient. Usage of
activators of what membrane cytoreceptors is fisiologically valid to decrease
attack?
Beta-adrenoreceptors
Н-cholinoreceptors
alpha- and beta-аdrenoreceptors
Alpha-аdrenoreceptors
М-cholinoreceptors
The type of lymphocyte which is predominant in chronic lymphocytic leukemia?
B-Lymphocyte
T-Lymphocyte
K-cells
Helper T-Lymphocytes
Examination 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:
Tryptophan
Tyrosine
Alanine
Methionine
Hystidine
A 50 year old patient has been taking treatment thrice for the last 6 months
because of fractures caused by domestic accidents. Microscopical examination of
bony tissue revealed foci of lacunar resolution, giant-cell granulomas in the
tumor-like formations, cysts. Bony tissue was substituted by fibrous connective
tissue. Examination revealed also adenoma of parathyroid gland and
hypercalcemia. What is the most probable diagnosis?

Parathyroid osteodystrophy
Osteopetrosis
Paget's disease
Osteomyelitis
Myelomatosis
β macroglobulin is derived from?
B-cells
T-cells
Both
None
The processes of heat transfer in a naked person at room temperature have
been studied. It was revealed that under these conditions the greatest amount
of heat is transferred by:
Heat radiation
Heat conduction
Convection
Evaporation
-
A 7-year-old child has acute onset of disease: temperature rise up to 38oC,
rhinitis, cough, lacrimation, and large-spot rash on the skin. Pharyngeal mucosa
is edematous, hyperemic, with whitish spots in the buccal area. What kind of
inflammation causes the changes in the buccal mucosa?
Catarrhal inflammation
Suppurative inflammation
Fibrinous inflammation
Hemorrhagic inflammation
Serous inflammation

All of the following are needed for clotting except?
Local stasis
Collagen
Platelets
Calcium
A 37-year-old woman presents to her physician complaining of difficulty reading
and fatigue. She reports having had a "pins and needles" feeling in her left arm
several months ago that resolved without treatment. On examination, visual
field deficits and mild hyperreflexia are noted. MRI confirms the suspected
diagnosis. Which of the following is the underlying mechanism of this patient's
disease?
Loss of oligodendrocytes
Antibodies to acetylcholine receptors
Axonal degeneration
Demyelination of the peripheral nerves
Loss of Schwann cells
Kidneys of a man under examination show increased resorbtion of calcium ions
and decreased resorbtion of phosphate ions. What hormone causes this
phenomenon?
Parathormone
Hormonal form D3
Aldosterone
Thyrocalcitonin
Vasopressin
Experimental stimulation of the sympathetic nerve branches that innervate the
heart caused an increase in the force of heart contractions because the
membrane of typical cardiomyocytes permitted an increase in:
Calcium ion entry

Calcium ion exit
Potassium ion exit
Potassium ion entry
Calcium and potassium ion exit
Which one of the following disorders of bilirubin metabolism shows increased
unconjugated bilirubin, normal conjugated bilirubin, and lack of bilirubin in the
urine?
Neonatal jaundice
Crigler-Najjar syndrome, types I and II
Hepatitis
Partial extrahepatic obstruction
A patient with chronic renal failure will be expected to have which of the
following findings due to the mechanisms described?
Hypermagnesemia due to decreased renal excretion
Prolonged bleeding due to decreased synthesis of clotting factors
Anemia due to increased red cell destruction
Hypercalcemic due to elevated PTH hormone
A couple came for medical genetic counseling. The man has hemophilia, the
woman is healthy and there were no cases of hemophilia in her family. What is
the risk of having a sick child in this family?
25%
100%
75%
50%
What is the chance of an infant getting Hepatitis-B congenitally if the mother is
HbsAg+ve and anti-HbeAg+ ve :
50%

0%
100%
Any of the above
Serum Iron levels are low in which one of the following conditions:
Iron deficiency anemia
Haemochromatosis
Thalassaemia major
Hemophilia
A male with a lesion of one of the CNS parts has asthenia, muscular dystonia,
balance disorder. Which CNS part has been affected?
Cerebellum
Black substance
Reticular formation
Red nuclei
Vestibular nuclei
Which is not associated with sickle cell anemia :
Leucopenia
Cardiomegaly
Ankle ulcer
Fish mouth vertebra
A patient has been given high doses of hydrocortisone for a long time. This
caused atrophy of one of the adrenal cortex zones. Which zone is it?
Fascial
Reticular
Glomerular and reticular

Glomerular
Which of the following is a primary neurogenic brain tumor?
Acoustic neuroma
Glioblastoma
Meningioma
Neuroblastoma
There are cortical and medullary substances separated by connective tissue
layer in the endocrine gland specimen. Parenchyma cells make up three zones
in cortical substance, with rounded masses in the superficial zone, parallel
chords in the middle one, reticular structure of cell chords in the deep one.
What gland is it?
Adrenal gland
Thyroid gland
Pituitary gland
Epiphysis
Hypothalamus
Glutamate decarboxylation results in formation of inhibitory transmitter in CNS.
Name it:
GABA
Glutathione
Serotonin
Histamine
Asparagine
ECG of a patient displays an abnormally long R wave (up to 0,18 s). This is
caused by a decrease in the conduction velocity of the following heart
structures:
Ventricles

Atria
Atrio-ventricular node
Right ventricle
Left ventricle
Since a patient has had myocardial infarction, atria and ventricles contract
independently from each other with a frequency of 60-70 and 35-40 per minute.
Specify the type of heart block in this case:
Complete atrioventricular
Partial atrioventricular
Sino-atrial
Intra-atrial
Intraventricular
A patient has been diagnosed with alkaptonuria. Choose an enzyme that can
cause this pathology when deficient:
Homogentisic acid oxidase
Phenylalanine hydroxylase
Glutamate dehydrogenase
Pyruvate dehydrogenase
Dioxyphenylalanine decarboxylase
Impaired platelet function is seen in following except:
Idiopathic thrombocytopenic purpura
Cryoglobulinemia
Multiple myeloma
Von Willebrand's disease

A patient ill with essential arterial hypertension had a hypertensive crisis that
resulted in an attack of cardiac asthma. What is the leading mechanism of
cardiac insufficiency in this case?
Heart overload caused by high pressure
Blood supply disturbance
Heart overload caused by increased blood volume
Myocardium damage
Absolute coronary insufficiency
A 30-year-old male patient with acute pancreatitis has been found to have a
disorder of cavitary protein digestion. The reason for such condition can be the
hyposynthesis and hyposecretion of the following enzyme:
Tripsin
Dipeptidase
Amylase
Lipase
Pepsin
Patients with erythropoietic porphyria (Gunther’s disease) have teeth that
fluoresce with bright red color when subjected to ultraviolet radiation; their skin
is light-sensitive, urine is red-colored. What enzyme can cause this disease,
when it is deficient?
Uroporphyrinogen III cosynthase
Uroporphyrinogen I synthase
Delta-aminolevulinate synthase
Uroporphyrinogen decarboxylase
Ferrochelatase
Which of these is the best therapy for preeclampsia?
Delivery of the baby
Antiseizure medication

Intravenous fluids
Antihypertensive medication
Anticoagulation
Which of the following measures has not been shown to retard progression of
renal failure?
Erythropoietin for anemia
Decrease in protein intake
ACE inhibitors above other antihypertensive
Aggressive BP control
Serum cholesterol level is raised in all of the ollowing except:
Massive parenchymatous liver damage
Nephrotic syndrome
Myxoedema
Obstructive jaundice
A 35-year-old woman has had episodes of abdominal pain and bloody diarrhea
for 4 to 5 years. Recently, the episodes became increasingly common, and she
noted a weight loss of about 10 pounds. She tells you that two of her uncles
have had similar symptoms “for years” and recently one of them had colon
cancer. On examination, there are no abdominal masses and no fistulas. The
most likely findings on colonoscopy with biopsy are:
Continuous inflammatory changes mostly confined to the mucosa
Patchy inflammatory lesions that extend throughout the bowel wall
Granulomas and fibrosis
Normal mucosa
Patchy inflammation of the mucosa with inflamed mesenteric fat and fibrosis
Secretion of which gastrointestinal hormones is primarily decreased in patient
with removed duodenum?

Cholecystokinin and secretin
Histamine
Gastrin and histamine
Gastrin
Neurotensin
You are seeing a pediatric patient from Djibouti in consultation who was
admitted with a constellation of symptoms including diarrhea, alopecia, muscle
wasting, depression, and a rash involving the face, extremities, and perineum.
The child has hypogonadism and dwarfism. You astutely make the diagnosis of
zinc deficiency, and laboratory test confirm this (zinc level <70 µL/dL). What
other clinical findings is this patient likely to manifest?
Hypopigmented hair
Hypochromic anemia
Hypoglycemia
Dissecting aortic aneurysm
Macrocytosis
Myelopthisic anemia is most commonly seen in:
Leukemia
Multiple myeloma
Metastatic carcinoma
Hodgkins lymphoma
Which is seen in Hemolytic uremic syndrome?
Hypofibrinogenemia
Thrombocytopenia
Coombs test positive
Uremia

Which of the following nephron segment is correctly paired with its function?
Collecting tubule and water regulation
Loop of Henle and potassium regulation
Proximal tubule and urinary concentration
Distal tubule and bicarbonate reclamation
As a result of an injury, the integrity of the anterior spinal cord root was
broken. Specify the neurons and their processes that had been damaged:
Axons of motor neurons
Motor neuron dendrites
Axons of sensory neurons
Dendrites of sensory neurons
Dendrites of association neurons
Conditions predisposing to leukemia include all except:
Infectious mononucleosis
Myelofibrosis
Ionising radiation
Polycythemia vera
Serum alkaline phosphatase may be elevated in the diseases of which organ?
Liver
Salivary glands
Spleen
Heart
Bladder
Which one of the following disorders of bilirubin metabolism shows increased
unconjugated bilirubin, increased conjugated bilirubin, and positive bilirubin in
the urine?

Hepatitis
Crigler-Najjar syndrome, types I and II
Neonatal jaundice
Gilbert’s syndrome
Ineffective erythropoiesis
A patient has acute bronchitis. The fever up to 38, 5oC had lasted for a week,
presently there is a decrease in temperature down to 37,0oC. Specify the
leading mechanism in the 3rd stage of fever:
Peripheral vasodilation
Increased heat production
Development of chill
Increased diuresis
Increased respiratory rate
As a result of a continuous chronic encephalopathy a patient has developed
spontaneous motions and disorder of torso muscle tone. These are the
symptoms of the disorder of the following conduction tract:
Tractus rubrospinalis
Tractus corticospinalis
Tractus corticonuclearis
Tractus spinothalamicus
Tractus tectospinalis
A 55-years-old male accident victim in casualty urgently yeeds blood. The blood
bank is unable to determine his ABO group, as his red cell group and plasma
group do not match. Emergency transfusion of patient should be with:
O-positive RBC and colloids crystalloid
Whole blood corresponding to his plasma group
RBC corresponding to his red cell group and colloids/crystalloid
AB negative whole blood

Patient have a history of recurrent attacks of heartbeats (paroxysms), profuse
sweating, headaches. Examination revealed hypertension, hyperglycemia,
increased basal metabolic rate, and tachycardia. These clinical presentations are
typical for the following adrenal pathology:
Hyperfunction of the medulla
Hypofunction of the medulla
Hyperfunction of the adrenal cortex
Hypofunction of the adrenal cortex
Primary aldosteronism
Transmission of hepatitis A is almost exclusively by:
Fecal-oral route
Intravenous drug abuse
Blood transfusion
Sexual
When taking exams students often have dry mouth. The mechanism that causes
this state results from the following reflexes:
Conditioned sympathetic
Unconditioned parasympathetic
Conditioned parasympathetic
Unconditioned sympathetic
Unconditioned peripheral
Which one disease is the single most common indication for single lung
transplantation?
Chronic obstructive pulmonary disease (COPD) either smoking induced or
secondary to α-1-antitrypsin deficiency
Cystic fibrosis
Lung cancer

Idiopathic pulmonary fibrosis (IPF)
Primary pulmonary hypertension (PPH)
For people adapted to high external temperatures profuse sweating is not
accompanied by loss of large volumes of sodium chloride. This is caused by the
effect the following hormone has on the perspiratory glands:
Aldosterone
Vasopressin
Cortisol
Tgyroxin
Natriuretic
Hyperkalemia may be caused by:
Trimethoprim
Albuterol
Licorice
Cisplatin
Mitral valve vegetations do not embolise usually to?
Lung
Liver
Spleen
Brain
An experimantal animal that was kept on protein-free diet developed fatty liver
infiltration, in particular as a result of deficiency of methylating agents. This is
caused by disturbed generation of the following metabolite:
Choline
Cholesterol
DOPA

Acetoacetate
Linoleic acid
In Huntington's disease, basal ganglia most commonly atrophied is:
Caudate nucleus
Putamen
Globus pallidus
Nucleus accumbens
Beta thalassemia is diagnosed by?
Hb electrophoresis
Shultzen test
Fragility test
All of the above
Infiltration of orbital soft tissue and extraocular muscles with lymphocytes,
mucopolysaccharides, and fluid is seen with?
Graves’ disease
Jod-Basedow phenomenon
Choriocarcinoma
Struma ovarii
Toxic multinodular goiter
A denaturation of proteins can be found in some substances. Specify the
substance that is used for the incomplete denaturation of hemoglobin:
Urea
Nitric acid
Toluene
Sodium hydroxide

Sulfuric acid
A patient operated on complicated appendicitis has the following changes of
blood count: erythrocytes - 4,0*1012/l, Нb - 120 g/l, color index - 0,9,
leukocytes – 18*109/l, basophils - 0, eosinophils – 0%, myelocytes – 0%,
juvenile – 0%, stab neutrophils – 20%, segmentonuclear neutrophils – 53%,
lymphocytes – 21%, monocytes – 5%. How is such nuclear shift of leukocytic
formula called?
Degenerative left shift
Regeneratively-degenerative
Regenerative left shift
Right shift
Hyperregenerative
The sequential activation of clotting factors in Phase-I of coagulation is as
follows :
Factor-XII, Factor-XI, Factor-IX, Factor-VIII
Factor-XII, Factor-VIII, Factor-XI, Factor-IX
Factor-VIII, Factor-XII, Factor-IX, Factor-XI
Factor-IX, Factor-VIII, Factor-XI, Factor-XII
Examination of a 43 y.o. patient revealed that his stomach has difficulties with
digestion of protein food. Gastric juice analysis revealed low acidity. Function of
which gastric cells is disturbed in this case?
Parietal exocrinocytes
Endocrinous cells
Mucous cells (mucocytes)
Main exocrinocytes
Cervical mucocytes
A 60-year-old patient has reduced perception of high-frequency sounds. What
structures' disorder of auditory analizer caused these changes?

Main membrane of cochlea near the oval window
Main membrane of cochlea near helicotrema
Muscles of middle ear
Tympanic membrane
Eustachian tube
Decrease in Osmotic Fragility causes Hemolysis in?
β thalassemia
α thalassemia
Sickle cell anemia
Meth Hemoglobinemia
Beta thalassemia is diagnosed in peripheral blood smear by :
Target cells
Nucleated RBC's
Anisocytosis
Helmet cells
A urologist refers a 20-year-old man because of hypospadias and infertility. He
has been sexually active since his early teens. Recently, he married and,
despite many attempts, his wife has been unable to become pregnant. The
likely site of his infertility is?
Posttesticular
Testicular
Pretesticular
Idiopathic
Which of the following is not seen in aplastic anaemia:
Splenomegly
Purpura

Haemorrhage
Anaemia
A patient on long-term lithium comes into your office complaining of polyuria;
you would expect his serum sodium to be?
Nearly normal because he is drinking increased amounts of water
Elevated because he has nephrogenic diabetes insipidus
Elevated because he has central diabetes insipidus
Low because he is suffering from psychogenic polydipsia
Which of these hormones blocks milk production during pregnancy?
Progesterone
Prolactin
Chorionic somatomammotropin
Thyroxine
Insulin
Autoimmune haemolytic anemia is seen in:
B-cell lymphoma
T-cell lymphoma
Acute myeloid leukemia (AML)
ALL
A middle-aged man comes to you with the single presenting symptom of
occasional hematuria of very recent onset. The most probable cause is :
Renal pelvic urothelial tumor
Renal cell carcinoma
Nephroblastoma
Acute pyelonephritis

Examination of a miner revealed pulmonary fibrosis accompanied by disturbance
of alveolar ventilation. What is the main mechanism of this disturbance?
Limitation of respiratory surface of lungs
Constriction of superior respiratory tracts
Disturbance of neural respiration control
Bronchi spasm
Limitation of breast mobility
Parkinson’s disease is caused by disruption of dopamine synthesis. What brain
structure synthesizes this neurotransmitter?
Substantia nigra
Globus pallidus
Corpora quadrigemina
Red nucleus
Hypothalamus
Which is seen in Hemolytic uremic syndrome :
Hypofibrinogenemia
Thrombocytopenia
Coombs test positive
Uremia
A doctor recommends a patient with duodenal ulcer to drink cabbage and potato
juice after the therapy course. Which substances contained in these vegetables
help to heal and prevent the ulcers?
Vitamin U
Vitamin K
Pantothenic acid
Vitamin C

Vitamin B1
On experiment on the dog the peripheral part of nervus vagus of the neck was
irritated. What changes of the heart function would be observed?
Decreased contraction rate
Increased contraction force and rate
Increased atrioventricular conduction
Increased contraction force
Increased myocardial excitability
An aged man had raise of arterial pressure under a stress. It was caused by
activation of:
Sympathoadrenal system
Functions of thyroid gland
Hypophysis function
Functions of adrenal cortex
Parasympathetic nucleus of vagus
Weakness is caused by diseased anterior horn cells in which of the following
disorders?
Amyotrophic lateral sclerosis
Botulism
Myasthenia gravis
Aminoglycoside antibiotic–associated weakness
Lambert-Eaton myasthenic syndrome
Echinocytes are types of:
RBC's
Lymphocytes
Monocytes

Platelets
The primary defect which leads to sickle cell anemia is:
Replacement of glutamate by valine in β-chain of HbA
An abnormality in porphyrin part of hemoglobin
A nonsense mutation in the β-chain of HbA
Substitution of valine by glutamate in the a-chain of HbA
Hereditary spherocytosis is due to — deficiency?
Cytokeratin
Invertin
Spectrin
All of the above
A patient in three weeks after acute myocardial infarction has pain in the heart
and joints and pneumonia. What is the main mechanism of development of
post-infarction Dressler’s syndrome?
Autoimmune inflammation
Vessels' thrombosis
Secondary infection
Ischemia of myocardium
Resorption of enzymes from necrotized area of myocardium
Alveolar space of the acinus was invaded by some bacteria which interacted
with the surfactant. This led to the activation of the cells that are localized in
the alveolar walls and on the surface. What cells are these?
Alveolar macrophages
Alveolocytes type I
Endothelial cells
Clara cells

Alveolocytes type II
A patient staying in the pulmonological department was diagnosed with
pulmonary emphysema accompanied by reduced elasticity of pulmonary tissue.
What type of respiration is observed?
Expiratory dyspnea
Periodic respiration
Superficial respiration
Infrequent respiration
Inspiratory dyspnea
A 4 year old child with hereditary renal lesion has signs of rickets, vitamin D
concentration in blood is normal. What is the most probable cause of rickets
development?
Impaired synthesis of calcitriol
Lack of calcium in food
Hypofunction of parathyroid glands
Hyperfunction of parathyroid glands
Increased excretion of calcium
A patient in your office tells you that he had an episode of vomiting bright red
blood twice in 1 day about 1 week ago, followed the next day by three or four
episodes of vomiting material that looked like coffee grounds. He could not
afford to seek medical help then and he said that “it got better except for the
pain.” The past 3 days he noticed black “sticky” stools and he finally came to
see you. What is your first concern?
Bleeding peptic ulcer
Bleeding from lung cancer
Crohn’s disease
Cirrhosis
Bleeding colon cancer

Examination of a 6-month-old child revealed a delay in closure of the occipital
fontanelle.When should it normally close?
Before 3 months
Before the child is born
Before 6 months
Before the end of the first year of life
Before the end of the second year of life
A patient has a critical impairment of protein, fat and hydrocarbon digestion.
Most likely it has been caused by low secretion of the following digestive juice:
Pancreatic juice
Saliva
Gastric juice
Bile
Intestinal juice
In the course of an experiment adenohypophysis of an animal has been
removed. The resulting atrophy of thyroid gland and adrenal cortex has been
caused by deficiency of the following hormone:
Tropic hormones
Thyroid hormones
Somatotropin
Cortisol
Thyroxin
Immediate antecedent of coronary thrombosis is?
Fissure in fibrous cap of a pearly plaque
Infected embolus
Blockade in blood flow
Hypercholesterolemia

A 15-year-old male comes into the office complaining about a lack of pubic hair
growth. He also informs you that his voice has not yet deepened, and he has no
interest in sexual activity. He is an only child. Blood drawn reveals a very high
testosterone level. What is the problem?
Androgen insensitivity
High FSH and LH
Low FSH and LH
Hyperthyroidism
XXY karyotype
A patient with a pathology of the cardiovascular system developed edemata of
the lower extremities. What is the mechanism of cardiac edema development?
Increased hydrostatic pressure at the venous end of the capillary
Increased oncotic pressure
Increased hydrostatic pressure at the arterial end of the capillary
Reduced osmotic pressure
Lymph efflux disorder
Which of the following is not required for successful breast-feeding?
High estrogen levels
Oxytocin
Good maternal nutrition
An intact neurologic axis
Prolactin
ECG of a patient with hyperfunction of thyroid gland showed heart hurry. It is
indicated by depression of the following ECG element:
R-R interval
P-T interval

P-Q interval
QRS complex
P-Q segment
A group of mountain climbers went through the blood analysis at the height of
3000 m. It revealed decrease of HCO3 to 15 micromol/l (standard is 22-26
mmol/l). What is the mechanism of HCO3, decrease?
Hyperventilation
Decrease of bicarbonate reabsorption in kidneys
Decrease of ammoniogenesis
Intensification of acidogenesis
Hypoventilation
Autoimmune thyroid disorders are usually associated with?
All of the above
Antithyroidglobulin antibodies
Antimicrosomal antibodies
Hypothyroidism
Middle part of cochlear of internal ear was destroyed in animal while
experiment. It will cause abnormalities of the sound perception of the following
frequencies:
Middle
High
High and low
No abnormalities
Low
Which of the following hormones is produced by both the ovary and uterus?
Relaxin

Activin
Follistatin
Inhibin
Enkephalin
A 2-year-old child experienced convulsions because of lowering calcium ions
concentration in the blood plasma. Function of what structure is decreased?
Parathyroid glands
Pineal gland
Thymus
Adrenal cortex
Hypophysis
Increase in Alkaline phosphatase is seen in?
Leukemoid reaction
Chronic mieloleucosis (CML)
Eosinophilia
Malaria
Lung of premature infant is presented on electronic photomicrography of biopsy
material. Collapse of the alveolar wall caused by the deficiency of surfactant
was revealed. Disfunction of what cells of the alveolar wall caused it?
Alveolocytes type II
Secretory cells
Fibroblasts
Alveolocytes type I
A 35 y.o. patient who often consumes alcohol was treated with diuretics. There
appeared serious muscle and heart weakness, vomiting, diarrhea. AP-100/60

mmHg depression. This condition is caused by intensified excretion with urine
of:
Potassium
Chlorine
Sodium
Calcium
Phosphates
D.I.C.is seen in:
Acute promyelocytic leukemia
Acute myelomonocytic leukemia
CMC
Autoimmune hemolytic anemia
ECG of a patient shows prolongation of T-wave. This is caused by deceleration
in ventricles of:
Repolarization
Contraction
Depolarization
Relaxation
Depolarization and repolarization
A 50-year-old patient was injured on the occipital region of the head. The closed
skull trauma was diagnosed. She was taken to the hospital. The medical
examination: deregulation of walking and balance, trembling of arms. What part
of brain was injured?
The cerebellum
The inter-brain
The mind-brain
The spinal cord

The medulla oblongata
Urine findings in SLE (Systemic Lupus Erythematosus):
Proteinuria
RBC casts
LE cells
None
A patient with tissue trauma was taken a blood sample for the determination of
blood clotting parameters. Specify the right sequence of extrinsic pathway
activation.
III – VIIa – Xa
III – VIII: TF – Xa
III – IV – Xa
IV – VIII: TF – Xa
IV – VIIa – Xa
Cardiac output is the product of:
Heart rate x stroke volume
Afterload x heart rate
Preload x stroke volume
Contractility x preload
Preload x heart rate
After the usage of acetylsalicylic acid a patient developed epigastric pain
because of exacerbation of his ulcer. What are the principles of this medication
ulcerogenity?
Antiprostaglandinic effect
Cholemic effect
Immunodepressive effect

Stimulation of pepsin secretion
Spasm of vessels
A 26-year-old woman is complaining of thirst and dryness in her mouth. The
examination has revealed glucosuria and blood glucose content of 6,5 mmol/l.
What condition are these symptoms the most typical for?
Renal diabetes
Steroid diabetes
Diabetes mellitus
Diabetes insipidus
Alimentary glucosuria
During an animal experiment, surgical damage of certain brain structures has
caused deep prolonged sleep. What structure is most likely to cause such
condition, if damaged?
Reticular formation
Basal ganglion
Red nuclei
Hippocampus
Cerebral cortex
A patient is diagnosed with iron deficiency sideroachrestic anemia, progression
of which is characterised by skin hyperpigmentation, pigmentary cirrhosis, heart
and pancreas affection. Iron level in the blood serum is increased. What
disorder of iron metabolism causes this disease?
Failure to assimilate iron leading to iron accumulation in tissues
Excessive iron intake with food
Disorder of iron absorption in bowels
Increased iron assimilation by body
–

First Hb to appear in fetal life :
HbF
HbA2
HbA
GowerHb
Part of alveoles of a preterm infant didn't spread because of enhanced elastic
recoil of lungs. How can this recoil be reduced?
By surfactant introduction
By pure oxygene inhalation
By glycose introduction
By artificial pulmonary ventilation
By fluid suction from the respiratory tracts
What is the most common mode of inheritance of Von Willebrand's disease :
Autosomal dominant
Autosomal recessive
X-linked recessive
Co-dominant
True about Haemophilia-A are all except?
Decreased Factor-VIII
Decreased PT
PTT increased
Soft tissue haematoma
14 days after quinsy a 15-year-old child presented with morning facial swelling,
high blood pressure, "meat slops" urine. Immunohistological study of a renal
biopsy sample revealed deposition of immune complexes on the basement

membranes of the capillaries and in the glomerular mesangium. What disease
developed in the patient?
Acute glomerulonephritis
Acute interstitial nephritis
Lipoid nephrosis
Acute pyelonephritis
Necrotizing nephrosis
Which of the hepatitis viruses most commonly progresses to chronic infection
and chronic hepatitis?
HCV
HBV
HAV
HEV
HGV
A 68-year-old woman can't move by the upper and lower right extremities due
to stroke. Muscle tone of these extremities and reflexes are increased. There
are pathological reflexes. What form of the paralysis is it?
Hemiplegia
Tetraplegia
Monoplegia
Dissociation
Paraplegia
A number of diseases can be diagnosed by evaluating activity of blood
transaminases. What vitamin is one of cofactors of these enzymes?
B6
B2
B1

B8
B5
In polycythaemia vera, it is usual to find?
Defective haemostasis
Megaloblastic erythropoeisis
Reduced leucocyte alkaline phosphatase
Reduced serum vitamin-B12 content
A 63 year old male patient who had been suffering from chronic diffuse
obstructive disease, pulmonary emphysema, for 15 years died from cardiac
insufficiency. Autopsy revealed nutmeg liver cirrhosis, cyanotic induration of
kidneys and spleen, ascites, edema of lower limbs. These changes of internal
organs are typical for the following disease:
Chronic right-ventricular insufficiency
Acute left-ventricular insufficiency
Acute right-ventricular insufficiency
General cardiac insufficiency
Chronic left-ventricular insufficiency
The normal total iron binding capacity is :
25-4 mg/litre
15-25 mg/litre
10-15 mg/litre
05-10 mg/litre
Which one of the hepatitis viruses is a DNA virus?
HBV
HAV
HCV

HEV
HGV
Microcytic hypochronic anemia is seen in following except:
Sickle cell anemia
Pregnant N’ Bleeding (PNB)
Thalassemia
Iron deficiency
The organ most vulnerable to ischemic changes due to shock is?
Heart
Lung
Liver
Kidneys
As a result of a craniocerebral injury a patient has a decreased skin sensitivity.
What area of the cerebral cortex may be damaged?
Posterior central gyrus
Occipital region
Cingulate gyrus
Frontal cortex
Anterior central gyrus
Which clinical or laboratory finding is most consistently seen in malabsorption
syndromes?
Steatorrhea
Iron overload
Elevated zinc levels in serum
Normal small bowel biopsy

Hypercalcemia
A peripheral segment of vagus nerve on a dogs neck was being stimulated in
course of an experiment. The following changes of cardiac activity could be
meanwhile observed:
Heart rate fall
Increased excitability of myocardium
Heart hurry
Heart rate and heart force amplification
Enhancement of atrioventricular conduction
Dystrophic changes of the heart muscle are accompanied with cardiac cavity
enlargement, decrease of the strength of heart contraction, increased amount of
blood, which remains in the heart during systolic phase, overfilled veins. For
what state of heart is it characteristic?
Myogenic dilatation
Emergency stage of hyperfunction and hypertrophy
Tonogenic dilatation
Cardiosclerosis
Tamponage of the heart
Characteristic sign of glycogenosis is muscle pain during physical work. Blood
examination usually reveals hypoglycemia. This pathology is caused by
congenital deficiency of the following enzyme:
Glycogen phosphorylase
Glucose 6-phosphate dehydrogenase
α-amylase
γ-amylase
Lysosomal glycosidase

A woman poisoned with unknown substance was hospitalised in a toxicological
department. What group of drugs can be administered to decrease absorption
and introduction of the poison to her body?
Adsorbents
Neuroleptics
Antioxidants
Organic nitrates
Cholinesterase inhibitors
Patient was on glucocorticoids for a long time, discontinuation of usage caused
exacerbation of the illness, decreased BP, weakness. How can you explain it?
Insufficiency of adrenal glands
Sensitization
Hyperproduction of ACTH
Adaptation to the medicine
Cumulation
A 55-year-old man who is a longtime alcoholic comes to the emergency room
after vomiting small amounts of bright red blood four times today. Your
differential diagnosis is constructed around causes of bleeding from the:
Upper gastrointestinal (GI) tract
Liver and pancreas
Kidneys
Lungs
Colon
Autopsy has revealed shrunken kidneys weighing 50 mg, with finegrained
surface and uniformly thinned substance. Microscopic investigation has shown
the thickening of arteriole walls due to accumulation of homogeneous anhistic
pink-coloured masses in them. Glomerules were undersized, sclerotic, with
atrophied tubules. What disease are these changes characteristic of?
Essential hypertension

Pyelonephritis with kidney shrinkage
Renal amyloidosis
Membranous nephropathy
A 46-year-old patient suffering from the diffuse toxic goiter underwent resection
of the thyroid gland. After the surgery the patient presents with appetite loss,
dyspepsia, increased neuromuscular excitement. The body weight remained
unchanged. Body temperature is normal. Which of the following has caused
such a condition in this patient?
Reduced production of parathormone
Reduced production of thyroxin
Increased production of thyroliberin
Increased production of calcitonin
Increased production of thyroxin
he skin pigmentation in bronze diabetes is due to?
Haemosiderin
Lipofuscin
Melanin
Ceroids
During determining the blood group according to the AB0 systemwith salt
solutions of monoclonal antibodies agglutination did not occur with any of the
solutions.What blood group is it?
0 (I)
А (II)
В (III)
АВ (IV)
-

In the histological microspecimen of red bone marrow there were revealed
multiple capillaries through the walls of which mature blood cells penetrated.
What type of capillaries is it?
Sinusoidal
Fenestrational
Somatic
Visceral
Lymphatic
Which disease presents with predominantly glomerular involvement?
Light chain deposition disease
Uric acid nephropathy
Lead nephropathy
Analgesic nephropathy
In beta thalassemia not true is :
Fragility of cells is increased
Serum normal increased or decreased
HbF is 15%
MCV and MCH are low
In a patient with hemolytic anemia, the following change is seen :
None of the above
Increase in Urine haemosiderin
Increase in Serum haptoglobulin
Serum bilirubin more than 15 mg/dl
A 43-year-old patient has thrombocytopenia, reduction of fibrinogen, products
of degradation of fibrin presented in the blood, petechial haemorrhage along
with septic shock. What is the most likely cause of the changes?

DIC-syndrome
Autoimmune thrombocytopenia
Exogenous intoxication
Disorder of thrombocytes production
Haemorrhagic diathesis
In which disorder is malabsorption due to diminished or absent digestive
enzymes?
Chronic pancreatitis
Crohn’s disease
Gastric surgery
Small bowel ischemia
Sigmoid resection
Which statement is true regarding the optic neuropathy that occurs with
combined use of cigarettes and alcohol?
Scotomas are present centrally
Color vision is not impaired
It is of sudden onset
It is reversible with B vitamin supplements and abstinence
The cells most sensitive to ischemia are?
Cortical neuron
Glial cells of brain
Renal tubular epithelium
Myocardial fibers
In course of a preventive examination of a miner a doctor revealed changes of
cardiovascular fitness which was indicative of cardiac insufficiency at the
compensation stage. What is the main proof of cardiac compensation?

Myocardium hypertrophy
Cyanosis
Dyspnea
Tachycardia
Rise of arterial pressure
Acute hyperkalemia is associated with which of the following
electrocardiographic changes?
QRS widening
Prolongation of the ST segment
A decrease in the PR interval
Prominent U waves
T-wave flattening
The most common post-transplant lymphoma cell type is:
B-cell
T-cell
Null-cell
NK-cell
Which is not secreted by Sertoli cells?
Androgens
Inhibin
Mullerian regression factor
None of the above
In anoxia, shock results from?
Increase in vascular bed
Acute circulatory failure

Psychogenic factors
Diminished cardiac output
Reduction in blood volume
In some regions of South Africa there is a spread sickle-shaped cell anemia, in
which erythrocytes have shape of a sickle as a result of substitution of
glutamine by valine in the hemoglobin molecule. What is the cause of this
disease?
Gene mutation
Disturbance of mechanisms of genetic information realization
Genomic mutations
Crossingover
Transduction
A patient with liver disease revealed the decreasing of prothrombin level in the
blood. It can, first of all, result in the impairment of:
The second phase of the coagulatory hemostasis
The first phase of the coagulatory hemostasis
Vascular-thrombocytic hemostasis
Anticoagulative properties of the blood
Fibrinolysis
In which one of the following diseases would the occurrence of hemoptysis
prompt a search for another disease as the cause of the hemoptysis?
Emphysema
Acute bronchitis
Goodpasture’s syndrome
Bronchogenic carcinoma
Bronchiectasis

Diseases of the respiratory system and circulatory disorders impair the
transport of oxygen, thus leading to hypoxia. Under these conditions the energy
metabolism is carried out by anaerobic glycolysis. As a result, the following
substance is generated and accumulated in blood:
Lactic acid
Pyruvic acid
Glutamic acid
Citric acid
Fumaric acid
A patient who had been taking diclofenac sodium for arthritis of mandibular
joint developed an acute condition of gastric ulcer. Such side effect of this
medicine is caused by inhibition of the following enzyme:
Cyclooxygenase-1 (COX-1)
Cyclooxygenase-2 (COX-2)
Lipoxygenase
Phosphodiesterase
Monoamine oxidase
Patient arrived to emergency care unit with shortness of breath, chest pain and
sweating. From his anamnesis known that he suffer from with cardial septal
defect and deep vein thrombosis. Doctor put diagnosis paradoxical embolism,
what means:
When an embolus arises in a vein but lodges in an artery
Embolism with amniotic fluid
Embolism with fat
Embolism with air
Gas embolism
Single best test to differentiate type of Jaundice is :
Urobilinogen

Serum bilirubin
Urine bile salts
Urine bilirubin
The pathologic findings of predominant small artery involvement with intimal
proliferation and sometimes with thrombosis, also termed “thrombotic
microangiopathy,” is found in which renal disease?
Hemolytic uremic syndrome
Membranoproliferative glomerulonephritis
Microscopic polyarteritis
Analgesic nephropathy
A 10-year-old girl has a history of repeated acute respiratory viral infection.
After recovering she presents with multiple petechial hemorrhages on the sites
of friction from clothing rubbing the skin. What kind of hypovitaminosis has this
girl?
C
B1
B2
B6
A
A 37-year-old woman complains of headache, vertigo, troubled sleep, numbness
of limbs. For the last 6 years she has been working at a gas-discharge lamp-
producing factory in a lead-processing shop. Blood test findings: low
hemoglobin and RBC level, serum iron concentration exceeds the norm by
several times. Specify the type of anemia:
Iron refractory anemia
Iron-deficiency anemia
Minkowsky-Shauffard disease
Hypoplastic anemia
Metaplastic anemia

You are counseling a patient who is recovering from long-standing anorexia
nervosa (AN). She is a 22-yearold woman who suffered the effects of AN for 8
years with a nadir body mass index of 17 kg/m2 and many laboratory
abnormalities during that time. Which of the following characteristics of AN is
least likely to improve despite successful lasting treatment of the disorder?
Low bone mass
Delayed gastric emptying
Lanugo
Amenorrhea
Salivary gland enlargement
All of the following are common consequences of congenital heart disease in the
adult except
Stroke
Erythrocytosis
Infective endocarditis
Pulmonary hypertension
Eisenmenger syndrome
A 60-year-old man after cerebral hemorrhage felt asleep for a long time.
Damage of what structure caused this state?
Reticular formation
Nuclears of the cerebral nerves
Cortex of the large hemispheres
Hippocampus
Black substances
A 64-year-old man complains of a resting tremor that lessens with intentional
movement and that causes him substantial embarrassment. What is the likely
cause?

Parkinson’s disease
Essential tremor
Asterixis
Hyperthyroidism
Drug-related tremor
In spontaneous bacterial peritonitis (SBP) typically:
As many as 70% of patients will experience at least one recurrence within 1
year of the first episode
Ascitic fluid usually has a high concentration of albumin
Persons with normal livers and persons with advanced liver disease are equally
likely to develop SBP
Pneumococcus or other gram-positive bacteria commonly cause this infection
The leukocyte count in ascitic fluid is usually low, less than 100 cells/μL
In course of an experiment thalamocortical tracts of an animal were cut. What
type of sensory perception remained intact?
Olfactory
Visual
Auditory
Exteroreceptive
Nociceptive
The clay colored pale stools are seen in :
Hepatic jaundice
Hemolytic jaundice
Amoebic hepatitis
In idiopathic thrombocytopaenic purpura?

Increase of megakaryocytes in marrow
Decrease of megakaryocytes in marrow
Increase of platelets in blood
None of the above
Which ECG leads represent the inferior cardiac wall?
II, III, aVF
V3, V4
aVR
I, aVL
V1, V2
On examination of a newborn boy’s external genitalia a fissure in the urethra
opening on the inferior surface of his penis is detected.What maldevelopment is
it?
Hypospadias
Hermaphroditism
Epispadia
Monorchism
Cryptorchidism
Urine bilirubin excretion is increased in :
Extrahepatic biliary atresia
Criggler Najjar syndrome
Dubin Johnson syndrome
Hemolytic anemia

Obturative jaundice developed in a 60-year-old patient because of malignant
tumour of the big papillary of the duodenal. Lumen of what anatomical structure
is squeezed with tumour?
Hepatopancreatic ampulla
Cystic duct
Common hepatic duct
Right hepatic duct
Left hepatic duct
Blood group antigen :
Sometimes found in saliva
Found in plasma proteins
Found attached to Hb molecule
Found in bone marrow
Of the following, the earliest step in the formation of a thrombus is?
Adherance of platelets to vascular intima
Trapping of erythrocytes
Formation of fibrin
Activation of Hageman's factor
A patient is diagnosed with hereditary coagulopathy that is characterised by
factor VIII deficiency. Specify the phase of blood clotting during which
coagulation will be disrupted in the given case:
Thromboplastin formation
Thrombin formation
Fibrin formation
Clot retraction
–

Most common cause of esophagitis:
Reflux disease
Alcohol
Smoking
Increased intake of spices
How do varicoceles cause male infertility?
Increasing testicular temperature
Decreasing testicular blood flow
Reduction of testosterone production
By causing testicular atrophy
During the fight, a man had a cardiac arrest due to the strong blow to the upper
region of the anterior abdominal wall. Which of the following mechanisms has
led to the cardiac arrest?
Parasympathetic unconditioned reflexes
Sympathetic unconditioned reflexes
Parasympathetic conditioned reflexes
Sympathetic conditioned reflexes
Peripheral reflexes
A 48-year-old patient after severe psychoemotional exertion suddenly began
feeling sharp pain in the heart region, irradiating into left arm. Nitroglycerin
releaved pain 10 minutes later. What pathogenetic mechanism is responsible for
the development of pain in this case?
Spasm of coronary vessels
Compression of coronary vessels
Dilation of peripheral vessels
Occlusion of coronary vessels
Increase of myocardial needs in oxygen

Sickle cell anemia is frequently associated with all of the following except:
Nephrosis
Fatty change in heart
Cholelithiasis
Hyperplastic bone marrow
Atria of an experimental animal were superdistended by blood that resulted in
decreased reabsorption of Na+ and water in renal tubules. This can be
explained by the influence of the following factor upon kidneys:
Natriuretic hormone
Vasopressin
Angiotensin
Aldosterone
Renin
Deficiency of Vit. E causes all except:
 sexual ability
Atherogenesis
Visual symptoms
Ataxia
Acute pancreatitis is caused by a variety of disorders. Which of the following
pairs of disorders account for 80 to 90% of cases?
Alcohol and gallstones
Trauma and hyperlipidemia
Trauma and gallstones
Hyperlipidemia and alcohol
Diabetes and viral illness

The tremor of which condition lessens with consumption of small amounts of
alcohol?
Essential tremor
Asterixis
Hyperthyroidism
Drug-related tremor
A patient who has been diabetic for 15 years comes to your office complaining
of a burning or tingling sensation in both of his feet and the lower aspects of
both legs, which bothers him especially at night. His most likely diagnosis is?
Polyneuropathy
Brown-Séquard’s syndrome
Mononeuropathy
Mononeuropathy multiplex
Radiculopathy
A 31-year-old male presents to the office due to infertility. On history, it is
revealed that he has Kartagener’s syndrome. Why is he infertile?
Asthenospermia
Oligospermia
Absence of the vas deferens
Epididymal obstruction
Undescended testes
A moderately obese factory worker who stands for long periods of time begins
to experience pain and a severe burning sensation that is localized over the left
anterior lateral thigh. This patient has a:
Mononeuropathy
Polyneuropathy

Radiculopathy
Which of the following is often noted during hypokalemia?
Prominent U wave
Prominent QRS complex
Long Q–T interval
Prominent P wave
J point elevation
Microspherocytes in peripheral blood smear are seen in:
All of the above
Autoimmune Acquired Hemolytic
Thalassaemia
Congenital Spherocytosis
Most common cause of hematuria in a young male is?
IgA nephropathy
Vesical calculus
Ac GN
Schistosomiasis
A 45-year-old man who has consumed excess alcohol for at least 20 years is
seen for evaluation of progressive difficulty in walking. He has an ataxic gait
and his muscles are generally hypotonic. He has an intention tremor in his arms
and legs and he also demonstrates “past pointing.” His primary brain pathology
will be found in the:
Cerebellum
Temporal lobe
Occipital cortex

Brainstem
Frontal cortex
A public utility specialist went down into a sewer well without protection and
after a while lost consciousness. Ambulance doctors diagnosed him with
hydrogen sulfide intoxication. What type of hypoxia developed?
Hemic
Overload
Tissue
Circulatory
Respiratory
Ascites forms in patients with cirrhosis when:
Portal hypertension and hypoalbuminemia are present
Hepatic lymph flow is decreased
Hypoalbuminemia alone is present
Portal hypertension alone is present
Hepatic lymph flow and aldosterone secretion are decreased
Which of these features represents a critical distinction between anorexia
nervosa and bulimia nervosa?
Underweight
Electrolyte abnormalities
Self-induced vomiting
Binge eating
A 45-year-old man complains of frequent “heartburn” and a mild chronic cough.
On examination, he has gastroesophageal reflux disease (GERD). In addition to
prescribing medications, which one of the following dietary recommendations
would you make?
Avoid fats, chocolates, and alcohol because they would decrease LES pressure

Avoid high-protein meals because they would increase lower esophageal
sphincter (LES) pressure
Eat high-carbohydrate food to increase overall GI motility
Eat high-protein meals to decrease LES pressure
Avoid concentrated carbohydrates to decrease dopamine secretion
True about idiopathic thrombocytopenic purpura :
It is diagnosed by poor clot retraction
Splenomegaly is present in a majority
Remits of its own without any treatment in all
Decrease in megakaryocytes in bone marrow
A 51-year-old man health care worker whom you examine for the first time
feels well. You do a complete physical examination, which is normal except for
slight overweight and borderline hypertension. It is interesting that his
laboratory studies show the following hepatitis B virus profile: positive HBsAg,
negative anti-HBs, low levels of IgG anti-HBc, positive anti-HBeAg, and negative
anti-HBe. The likely diagnosis is?
Chronic HBV infection, high infectivity
Late-acute HBV, low infectivity
Recovered from HBV infection
Acute HBV infection, high infectivity
Immunization with HBsAg vaccine
Histopathologic features of chronic heart transplant rejection include all of the
following except:
Large areas of myocytolysis with giant cell formation
Intimal fibrosis
Infiltrate of lymphocytes plasma cell and histiocytes in the perivascular regions
of the myocardium
Destructive arthritis

A 40-year-old female diabetic has glycosuria. This finding may be attributed to
inadequate glucose reabsorption at which of the following sites?
Proximal convoluted tubule
Distal convoluted tubule
Glomerulus
Loop of Henle
Collecting duct
You are rotating on a medical trip to impoverished areas of China. You are
examining an 8-year-old child whose mother complains of him being clumsy and
sickly. He has had many episodes of diarrheal illnesses and pneumonia. His
“clumsiness” is most pronounced in the evening when he has to go outside and
do his chores. On examination, you notice conjunctival dryness with white
patches of keratinized epithelium on the sclera. What is the cause of this child’s
symptoms?
Vitamin A deficiency
Congenital rubella
Spinocerebellar ataxia (SCA) type 1
Autoimmune neutropenia
Vitamin B1 deficiency
Allergic bronchopulmonary aspergillosis is related to sarcoidosis involving the
lung by which cell type :
Eosinophil
Plasma cell
Macrophage
Type-II pneumocyte
A 36-year-old female patient has a history of collagen disease. Urine analysis is
likely to reveal an increased concentration of the following metabolite:
Oxyproline

Indican
Creatinine
Urea
Urobilinogen
A 25-year-old graduate student is injured in a fall during a weekend rock
climbing expedition. There is serious damage to the peripheral nerves in his leg.
Which of the following can be expected to occur?
Normal motor function may never return
Individual muscle fibers will not be able to contract spontaneously
Groups of muscle fibers will not be able to spontaneously discharge
Denervated muscles will hypertrophy
Muscle bulk may increase by one-half within 2 to 3 months
Patient 54 year-old, 5th day after surgical operation. Blood count: Erythrocytes
3,6*1012/l, Hemoglobin 95 g/l, Erythrocyte’s hemoglobin content (color index)
0,78; Leukocytes 16*109/l, Platelets 450*109/l Blood picture: anizocytosis,
poikilocytosis, reticulocytes- 3,8%. What anemia does this patient have?
Anemia from iron deficiency
Acquired hemolytic anemia
Acute posthemorragic anemia
Chronic posthemorragic anemia
Hypoplastic anemia
A man who was stabbed in the back during a fight is brought to the emergency
room. On examination you find impaired pain and temperature sensation in one
leg and impaired proprioception and vibration sense in the opposite leg. These
findings are descriptive of a:
Mononeuropathy
Polyneuropathy

Radiculopathy
Murphy's triad of pain, vomiting and fever is seen in :
Appendicitis
Cholecystitis
Pancreatitis
UTI
Reiter's disease
A 52-year-old female presents to the office with a complaint of hot flashes. You
suspect menopause. Which of the findings below would confirm your diagnosis?
High FSH and LH
Normal or low estrogen level
Normal prolactin level
Normal androgen level
High androgen level
A 30-year-old patient’s blood test revealed the following: erythrocyte count is
6*1012/l, hemoglobin is 10,55 mmol/l. Vaquez’s disease was diagnosed. Name
the leading part of pathogenesis:
Neoplastic erythroid hyperplasia
Iron-deficiency
B12-deficiency
Hypoxia
Acidosis
A 27-year-old man presents with recurrent episodes of intensely pruritic vesicles
symmetrically distributed on his trunk. On electron microscopy, granular
deposition of 19A and complement is noted at the dermoepidermal junction.

Which of the following underlying conditions predisposes patients to the
described skin disorder?
Celiac sprue
Lactase deficiency
Tropical sprue
Ulcerative colitis
Whipple disease
All are seen in B12 deficiency except:
Thrombocytopenia
Hypersegmented neutrophils
Macrocytosis
Ineffective erythropoiesis
A concentrated solution of sodium chloride was intravenously injected to an
animal. This caused decreased reabsorption of sodium ions in the renal tubules.
It is the result of the following changes of hormonal secretion:
Aldosterone reduction
Vasopressin reduction
Vasopressin increase
Reduction of atrial natriuretic factor
Aldosterone increase
Hyponatremia with a low urine sodium is associated with?
congestive heart failure
SIADH
recent thiazide use
hypothyroidism

A 30-year-old woman presents with a 6-month history of amenorrhea. Your
initial evaluation should include measurement of:
Prolactin
Estradiol
Progesterone
Testosterone
DHEA-S
In Thalassemia, all of the following are seen except:
Increase osmotic fragility
Mongoloid facies
Target cells
Microcytic hypochromic anemia
Testosterone and it's analogs increase the mass of skeletal muscles that allows
to use them for treatment of dystrophy. Due to interaction of the hormone with
what cell substance is this action caused?
Nuclear receptors
Membrane receptors
Ribosomes
Chromatin
Proteins- activators of transcription
Which finding is fairly specific for chronic renal failure?
Broad casts in urinalysis
Hyaline casts
Anemia
Proteinuria
Hypocalcemia

Common site of haemopoiesis in fetus is:
Liver
Spleen
Bone marrow
Gut
A 60-year-old patient with a long history of stenocardia takes coronary dilator
agents. He has also been administered acetylsalicylic acid to reduce platelet
aggregation. What is the mechanism of antiplatelet action of acetylsalicylic acid?
It reduces the activity of cyclooxygenase
It reduces the activity of phosphodiesterase
It enhances the activity of platelet adenylate cyclase
It enhances the synthesis of prostacyclin
It has membrane stabilizing effect
The one state prothrombin time is an index of the function of:
Extrinsic pathway of coagulation
Intrinsic pathway of coagulation
Platelet function
Capillary function
Tne pathogenesis of hypochromic anemia in lead poisoning is due to :
Inhibition of enzymes involved in heme biosynthesis
Binding of lead to transferrin, inhibiting the transport of iron
Binding of leading to cell membrane of erythroid precursors
Binding of lead to ferritin inhibiting their breakdown into hemosiderin
Which of the following occurs during systole?
The ventricles contract

The atrioventricular (AV) valves are open
Rapid ventricular filling occurs
Blood passes from atria into the ventricles
Atrial contraction propels final proportion of blood into ventricles
Gastric ulcer is caused due to :
Decreased mucosal resistance
Hyperacidity
Bile acid reflux
Recurrent trauma
Hepatitis has led to the development of hepatic failure. Mechanism of edemata
formation is activated by the impairment of the following liver function:
Protein-synthetic
Barrier
Chologenetic
Antitoxic
Glycogen-synthetic
Symptoms of pellagra (vitamin PP deficiency) is particularly pronounced in
patients with low protein diet, because nicotinamide precursor in humans is one
of the essential amino acids, namely:
Tryptophan
Threonine
Arginine
Histidine
Lysine
A drycleaner’s worker has been found to have hepatic steatosis. This pathology
can be caused by the disruption of synthesis of the following substance:

Phosphatidylcholine
Tristearin
Urea
Phosphatidic acid
Cholic acid
Which of the following is the correct sequence for myocardial depolarization?
Sinoatrial (SA node) →AV node →bundle of His →right and left ventricles
Bundle of His →AV node →left ventricle
AV node →bundle of His →atria
SA node →left ventricle →bundle of His
24 hours after appendectomy blood of a patient presents neutrophilic
leukocytosis with regenerative shift. What is the most probable mechanism of
leukocytosis development?
Amplification of leukopoesis
Decelerated leukocyte destruction
Decelerated emigration of leukocytes to the tissues
Amplification of leukopoesis and decelerated emigration of leukocytes to the
tissues
Redistribution of leukocytes in the organism
24 hours after appendectomy blood of a patient presents neutrophilic
leukocytosis with regenerative shift. What is the most probable mechanism of
leukocytosis development?
Amplification of leukopoiesis and decelerated emigration of leukocytes to the
tissues
Amplification of leukopoiesis
Redistribution of leukocytes in the organism
Decelerated emigration of leukocytes to the tissues
Decelerated leukocyte destruction

In a dysentery patient undergoing treatment in the contagious isolation ward, a
significant increase in packed cell volume has been observed (60%). What other
value will be affected by this change?
Increasing blood viscosity
Increasing volume of blood circulation
Leukopenia
Thrombocytopenia
Increasing erythrocyte sedimentation rate (ESR)
Work in a mine is known to cause inhalation of large amounts of coal dust.
Inhaled coal dust can be detected in the following pulmonary cells:
Respiratory epithelial cells
Secretory epithelial cells
Capillary endothelial cells
Pericapillary cells
After intake of rich food a patient feels nausea and sluggishness: with time
there appeared signs of steatorrhea. Blood cholesterine concentration is 9.2
micromole/l. This condition was caused by lack of:
Bile acids
Chylomicrons
Triglycerides
Fatty acids
Phospholipids
Prior to glucose utilization in cells it is transported inside cells from extracellular
space through plasmatic membrane. This process is stimulated by the following
hormone:
Insulin

Glucagon
Thyroxin
Aldosterone
Adrenalin
Most pulmonary infarcts are:
Secondary
Asymptomatic
White
All of these
None of these
When blood circulation in the damaged tissue is restored, lactate accumulation
stops and glucose consumption decelerates. These metabolic changes are
caused by activation of the following process:
Aerobic glycolysis
Anaerobic glycolysis
Lipolysis
Gluconeogenesis
Glycogen biosynthesis
Smoky urine with RBC's casts and protein is the characteristic finding of?
Chronic glomerulonephritis
Nephrotic syndrome
Renal calculi
Electrocardiogram of a young man reveals deviation of his electrical axis of
heart to the left. This phenomenon can be caused by:
Hypersthenic body type

Asthenic body type
Dilation of the right atrium
Dilation of the right ventricle
Dilation of the left atrium
Type I diabetes mellitus is associated with all the following except?
В cell degranulation
Reduction in В cell mass
Insulitis
Amyloid change in В cells
A 38-year-old female patient complains of general weakness, cardiac pain,
increased appetite, no menstruation. Objectively: the height is 166 cm, weight
108 kg, the patient has moon-shaped face, subcutaneous fat is deposited
mainly in the upper body, torso and hips. There are also blood-red streaks. Ps-
62/min, AP- 160/105 mm Hg. Which of the following diseases is the described
pattern of obesity most typical for?
Cushing pituitary basophilism
Alimentary obesity
Myxedema
Insulinoma
Babinski-Frohlich syndrome
A 38-year-old woman comes into the office with complaints of amenorrhea for 6
months, with increased cold intolerance, loss of energy, and hair loss. Her
menses were normal until this episode started, and she has also gained 22
pounds over these 6 months. Her pregnancy test is negative. Which test would
you now order?
TSH
Estrogen levels
Testosterone level
FSH and LH

Cortisol level
Increased venous thrombosis in pregnancy is due to :
Increased hepatic production of clotting factors
Increased antithrombin-III levels
Changes in blood viscosity
Increased progesterone
When a patient with traumatic impairment of the brain was examined, it was
discovered that he had stopped to distinguish displacement of an object on the
skin. What part of the brain was damaged?
Posterior central gurus
Frontal zone
Frontal central gurus
Parietal zone of the cortex
Occipital zone of the cortex
Hepatocellular adenomas:
Have multiple hepatocellular adenomas associated with glycogen storage
disease type I
Are mostly malignant
Do not have hormones playing a role in their pathogenesis
Occur predominantly in the left lobe of the liver
Occur predominantly in men
A woman complains of visual impairment. Examination revealed obesity in the
patient and her fasting plasma glucose level is hyperglycemic. What diabetes
complication can cause visual impairment/blindness?
Microangiopathy
Macroangiopathy

Atherosclerosis
Neuropathy
Glomerulopathy
A patient complains of pain in the heart area during acute attack of gastric
ulcer. What vegetative reflex can cause this painful feeling?
Viscerovisceral reflex
Viscerodermal reflex
Visceromotor reflex
Dermatovisceral reflex
Motor-visceral reflex
The macrophages in the brain are:
Astrocytes
Oligodendrocytes
Microgyria
Monocytes
A neonate develops marked unconjugated hyperbilirubinemia. Liver function
tests are normal. No bilirubin is found in the urine. This infant’s condition
continues to deteriorate, and he dies at 2 weeks of age. To which of the
following conditions did the infant most likely succumb?
Crigler-Najjar syndrome
Dubin-Johnson syndrome
Gilbert syndrome
Rotor syndrome
Reye syndrome
A man having a hearing loss after a head trauma was delivered to the
neurosurgery department. The cause of the hearing loss might be the damage
of the following lobe of cerebral cortex:

Temporal
Occipital
Frontal
Parietal
Postcentral gyrus
A patient had a trauma that caused dysfunction of motor centres regulating
activity of head muscles. In what parts of cerebral cortex can the respective
centre normally be located?
Inferior part of precentral gyrus
Superior part of precentral gyrus
Supramarginal gyrus
Superior parietal lobule
Angular gyrus
A 47 year old man with myocardium infarction was admitted to the cardiological
department. What changes of cellular composition of peripheral blood are
induced by necrotic changes in the myocardium?
Neutrophilic leukocytosis
Eosinophilic leukocytosis
Monocytosis
Lymphopenia
Thrombocytopenia
Thrombocytosis is a recognised feature of?
Myelofibrosis
Systemic lupus erythematosis
Azidothymidline therapy
Myelodysplastic syndrome

A 46 year old woman suffering from chololithiasis developed jaundice. Her urine
became dark-yellow and feces became colourless. Blood serum will have the
highest concentration of the following substance:
Conjugated bilirubin
Urobilinogen
Biliverdin
Mesobilirubin
Unconjugated bilirubin
Which of the following hormones is produced both by the theca and the kidney?
Renin
Relaxin
Inhibin
Epidermal growth factor-like
Transforming growth factor-β
A 19-year-old male was found to have an elevated level of potassium in the
secondary urine. These changes might have been caused by the increase in the
following hormone level:
Aldosterone
Oxytocin
Adrenaline
Glucagon
Testosterone
Concerning the association between potassium and bicarbonate abnormalities,
which of the following is true?
Metabolic alkalosis is associated with volume depletion caused by diuretics
The regulation of potassium excretion occurs largely in the loop of Henle, and
this is why loop diuretics cause hypokalemia
Hypokalemia generally results in the increased production of aldosterone

Volume depletion inhibits reabsorption of bicarbonate in the proximal tubule
Bone marrow aspiration is essential to diagnose?
Megaloblastic anemia
Hemolytic anemia
Chronic myeloid leukemia
A 46-year-old woman who is clearly jaundiced is seen in clinic. Laboratory tests
reveal conjugated hyperbilirubinemia. Urine bilirubin levels are significantly
above normal, while urine urobilinogen levels are significantly below normal.
Which of the following mechanisms is the most likely cause of her jaundice?
Blockage of the common bile duct
Deficiency of glucuronyl transferase
Hemolytic anemia
Hepatocellular damage
Degenerative changes in posterior and lateral columns of spinal cord (funicular
myelosis) caused by methylmalonic acid accumulation occur in patients with
B12-deficiency anemia. This results in synthesis disruption of the following
substance:
Myelin
Acetylcholine
Norepinephrine
Dopamine
Serotonin
AH are true about polycythemia vera except:
Increased erythropoetin level
Increased LAP score
Splenomegaly

May cause Budd Chiari syndrome
A 16-year-old boy presents without pubertal development or development of
secondary sexual characteristics. He cannot smell (anosmia). The baseline
testosterone and the LH response to LHRH most likely are?
Low testosterone and normal LHRH response
Normal testosterone and normal LHRH response
High testosterone and normal LHRH response
Low testosterone and no LHRH response
Low testosterone and exaggerated LHRH response
What is one of the effects of splenectomy?
Increased susceptibility to systemic bacterial infections
Chronic hemolytic anemia
Increased likelihood of developing leukemias and lymphomas
Pernicious anemia
Sickle cell anemia
Megaloblastic bone marrow reaction is seen in :
Pernicious anaemia
Sickle cell anaemia
Thalassaemia
Idiopathic thrombocytopenic purpura
Thrombomodulin:
Binds with thrombin to cause anticoagulation by forming protein-C
Binds with thrombin to cause thrombosis by forming protein-S
Binds with prothrombin to form thrombin
Causes fibrinolysis

A 3-year-old child has continuous fever, lymph nodes are enlarged, the amount
of lymphocytes in blood is significantly increased. Enzyme linked
immunosorbent assay (ELISA) revealed antigen of Epstein-Barr virus. What
diagnosis can be made based on the information given above?
Infectious mononucleosis
Burkitt’s lymphoma
Herpetic lymphadenopathy
Generalized infection caused by herpes-zoster
Cytomegalovirus infection
Which of the following is represented by a prolonged PR interval and is due to
delayed AV conduction?
First-degree AV block
Third-degree AV block type
Second-degree AV block type I
Asystole
Second-degree AV block type II
Prerenal azotemia is associated with?
Evolution to acute tubular necrosis if untreated
Granular casts in the urine
Use of angiotensin-converting enzyme (ACE) inhibitors in unilateral renal artery
stenosis
High fractional excretion of sodium
The calcium canals of cardiomyocytes have been blocked on an isolated rabbit's
heart. What changes in the heart's activity can happen as a result?
Decreased rate and force of heart beat
Decreased heart beat rate
Decreased force of the contraction

Heart stops in diastole
Heart stops in systole
Which of the following is most likely to cause a hypochromic microcytic anemia?
Folate deficiency
Sickle cell anemia
Vitamin B12deficiency
A 50-year-old woman is being treated for shingles in a neurology unit.What
reactivated virus causes this disease?
Varicella zoster virus (chickenpox virus)
Herpes simplex virus type 1
Herpes simplex virus type 2
Measles virus
Cytomegalovirus
Blood sampling for bulk analysis is recommended to be performed on an empty
stomach and in the morning. What changes in blood composition can occur if to
perform blood sampling after food intake?
Increased contents of leukocytes
Increased contents of erythrocytes
Reduced contents of erythrocytes
Increased plasma proteins
Reduced contents of thrombocytes
A patient with signs of osteoporosis and urolithiasis has been admitted to the
endocrinology department. Blood test has revealed hypercalcemia and
hypophosphatemia. These changes are associated with abnormal synthesis of
the following hormone:

Parathyroid hormone
Calcitonin
Cortisol
Aldosterone
Calcitriol
A 25-year-old woman presents with increasing obesity, amenorrhea,
hypertension, and abdominal stria. The next best diagnostic test is?
Overnight dexamethasone suppression test
Free T4 and TSH
Prolactin
Random cortisol
ACTH
A 30-year-old man comes to your office with complaints of fatigue, anorexia,
nausea, and vomiting. He does not have fever. His urine is dark. On physical
examination, his liver is slightly enlarged and minimally tender. He does not
have edema or spider angiomata. Laboratory tests show the following: negative
HBsAg, negative IgM anti-HAV, positive IgM anti-HBc, and negative anti-HCV.
The most likely diagnosis is?
Acute hepatitis B
Acute hepatitis A
Acute hepatitis A and B
Chronic hepatitis B
Acute hepatitis C
Following are seen as pathological findings in a case of hypertension except:
Cardiac capillary network 
Cardiac size 
Concentric hypertrophy of heart
T size of cardiac fibres

The most common variety of thyroid cancer is?
Papillary thyroid carcinoma
Medullary thyroid carcinoma
Thyroid lymphoma
Anaplastic thyroid carcinoma
Follicular thyroid carcinoma
In the course of an experiment there has been increase in nerve conduction
velocity. This may be caused by increase in concentration of the following ions
that are present in the solution around the cell:
Na+
K+ and Cl−
K+ and Na+
Ca2+ and Cl−
Ca2+
Commonest presentation of Endemic goiter is?
Lump in neck
Hypothyroidism
Asymptomatic
Hyperthyroidism
A patient complains that at the bare mention of the tragic events that once
occurred in his life he experiences tachycardia, dyspnea and an abrupt rise in
blood pressure. What structures of the CNS are responsible for these
cardiorespiratory reactions in this patient?
Cerebral cortex
Cerebellum
Lateral hypothalamic nuclei

Specific thalamic nuclei
Quadrigemina of mesencephalon
Blood sampling for bulk analysis is recommended to be performed on an empty
stomach and in the morning. What changes in blood count can occur if to
perform blood sampling after food intake?
Increased contents of leukocytes
Increased plasma proteins
Increased contents of erythrocytes
Reduced contents of thrombocytes
Reduced contents of erythrocytes
Findings of intravascular hemolysis are except:
Increased haptoglobulins
Increased hemosiderinuria
Increased hemoglobulinuria
Hemoglobinemia
 haptoglobulins
A patient has insufficient blood supply to the kidneys, which has caused the
development of pressor effect due to the constriction of arterial resistance
vessels. This is the result of the vessels being greately affected by the following
substance:
Angiotensin II
Angiotensinogen
Renin
Catecholamines
Norepinephrine
While in the ICU, you are called to your patient’s bedside because of the
development of seizure activity in a ventilator patient with nosocomial

pneumonia. You review the situation including the medication record. The
patient is currently receiving dopamine, one-half normal saline, imipenem
cilastatin, tobramycin, lisinopril, clonidine patch, and famotidine. The laboratory
test results from this morning show normal electrolytes, except for a mildly
elevated creatinine of 2,4 that is chronic, and CBC shows an improving white
blood count of 15,000. After stopping the acute seizure event, you determine
the next step in preventing further seizures is?
Change antibiotic coverage
Stop clonidine
Intravenous phenytoin
Stop dopamine
CT of the head
Serum alkaline phosphatase is elevated in :
Diabetes mellitus
Prostatic carcinoma
Pancreatic disease
Electrical activity of neurons is being measured. They fire prior to and at the
beginning of inhalation. Where are these neurons situated?
Medulla oblongata
Diencephalon
Mesencephalon
Spinal cord
Cerebral cortex
A patient with marked pneumofibrosis that developed after infiltrating
pulmonary tuberculosis has been diagnosed with respiratory failure. What is its
pathogenetic type?
Restrictive
Obstructive

Reflex
Apneistic
Dysregulatory
Having helped to eliminate consequences of a failure at a nuclear power plant, a
worker got an irradiation doze of 500 roentgen. He complains of headache,
nausea, dizziness. What changes in leukocytes quantity can be expected 10
hours after irradiation?
Neutrophilic leukocytosis
Lymphocytosis
Leukopenia
Leukemia
Agranulocytosis
Periodic renal colics attackes are observed in the woman with primary
hyperparathyroidism. Ultrasonic examination revealed small stones in the
kidneys. What is the cause of the formation of the stones?
Hypercalcemia
Hyperuricemia
Hyperkalemia
Hypercholesterinemia
Hyperphosphatemia
High levels of thyroidal peroxidase antibody are found with?
Hashimoto’s thyroiditis
Lithium
Iodine deficiency
Propylthiouracil

A 38-year-old male patient has been ill with systemic lupus erythematosus
(SLE) for three years. He was diagnosed with diffuse renal affection
accompanied by massive edema and expressive proteinuria. What is the most
likely cause of proteinuria development?
Autoimmune renal affection
Urinary bladder inflammation
Urinary tracts inflammation
Aseptic renal affection
Ischemic renal affection
In an elderly person the change in heart force and vessels physical properties
were detected; they can be clearly observed on graphic recording of carotid
pulse waves. What method was applied?
Sphygmography
Plethysmography
Rheography
Myography
Phlebography
Emotional stress causes activation of hormon-sensitive triglyceride lipase in the
adipocytes. What secondary mediator takes part in this process?
Cyclic adenosine monophosphate
Cyclic guanosine monophosphate
Adenosine monophosphate
Diacylglycerol
Ions of Ca2+
A patient has a hemorrhage into the posterior central gyrus. What type of
sensitivity on the opposite side will be disturbed?
Skin and proprioceptive
Auditory

Visual
Olfactory
Auditory and visual
Examination of a 43 y.o. anephric patient revealed anemia symptoms. What is
the cause of these symptoms?
Reduced synthesis of erythropoietins
Vitamin B12 deficit
Folic acid deficit
Enhanced destruction of erythrocytes
Iron deficit
In the treatment of persons with hepatic encephalopathy, which one of the
following acts decreases ammonia absorption?
Lactulose
Sucrose
Protein
Glucose
Galactose
A patient suffering from thyrotoxicosis symptoms of vegetoasthenic syndrome
was revealed. What of the following would show the histological appearance of a
thyroid gland being stimulated by thyroid-stimulating hormone (TSH)?
Columnar-shaped follicular cells
Decreased numbers of follicular cells
Decreased numbers of parafollicular capillaries
An abundance of colloid in the lumen of the follicle
Increased numbers of parafollicular cells

A 29-year-old woman comes into the office after three spontaneous abortions
(unplanned). All three occurred at approximately 6 weeks’ gestational age. Her
physical exam is normal. Which of these may be the cause?
Ovary
Thyroid gland
Adrenal gland
Pituitary gland
Which of the following describes bone abnormalities in patients with chronic
renal failure?
Hyperparathyroidism responds well to 1,25 dihydroxy vitamin D
Adynamic bone disease is associated with myopathy
Osteomalacia is due to excessive accumulation of magnesium
Osteitis fibrosis cystica is a result of over suppression of PTH
Amyloidosis is similar in etiology to patients who are not on dialysis
Although, more than 400 blood groups have been identi¬fied, the ABO blood
group system remains the most important in clinical medicine because :
ABO (H) antigens are present in most body tissues and fluids
It has four different blood groups A, B, AB, O(H)
It was the blood group system to be discovered
ABO (H) antibodies are invariably present in plasma when persons RBC lacks
the corresponding antigen
In the blood of a 26-year-old man 18% of erythrocytes of the spherical, ball-
shaped, flat and thorn-like shape have been revealed. Other erythrocytes were
in the form of the concavo-concave disks. How is this phenomenon called?
Physiological poikilocytosis
Erythrocytosis
Pathological poikilocytosis
Physiological anisocytosis

Pathological anisocytosis
Diabetic nephropathy with uremia has developed in a patient with pancreatic
diabetes. The velocity of glomerular filtration is 9 ml/min. What mechanism of a
decrease in glomerular filtration velocity and chronic renal failure development
is most likely in the case of this patient?
Reduction of active nephron mass
Decrease in systemic arterial pressure
Obstruction of nephron tubules with hyaline casts
Tissue acidosis
Arteriolar spasm
Pretibial myxedema is associated with?
Graves’ disease
Jod-Basedow phenomenon
Choriocarcinoma
Struma ovarii
The type of anemia seen in chronic infections is:
Normocytic, normochromic
Normocytic, hypochromic
Dimorphic type
Microcytic, hypochromic
A 25-year-old man with a high-frequency fine tremor that may be difficult to
see grossly has:
Hyperthyroidism
Essential tremor
Asterixis

Drug-related tremor
The clinical symptoms, signs, and outcomes following acute liver injury
associated with viral hepatitis are as a consequence of the:
Immunologic response of the host (the person infected), involving cytolytic T
cells
Virus directly cytopathic to lymphoid cells in the liver
Virus directly cytopathic for liver cells (hepatocytes)
Primary action of viral polymerase on hepatocytes
Virus antibody acting on hepatocytes and lymphoid cells
In the course of an experiment thalamocortical tracts of an animal were cut.
What type of sensory perception remained intact?
Olfactory
Auditory
Exteroreceptive
Visual
Nociceptive
A 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. This condition might be caused by:
Sickle-cell anemia
Addison's disease
Hepatocellular jaundice
Acute intermittent porphyria
Obturative jaundice
A 35-year-old male developed acute heart failure while running for a long time.
What changes in the ionic composition can be observed in the cardiac muscle?

Accumulation of Na+ and Ca2+ ions in the myocardium cells
Accumulation of K+ and Mg2+ ions in the myocardium cells
Reduction of Na+ and Ca2+ ions in the myocardium cells
Reduction of K+ and Mg2+ ions in the extracellular space
Reduction of Na+ and Ca2+ ions in the extracellular space
A patient with jaundice has high total bilirubin that is mainly indirect
(unconjugated), high concentration of stercobilin in the stool and urine. The
level of direct (conjugated) bilirubin in the blood plasma is normal. What kind of
jaundice can you think of?
Hemolytic
Parenchymal (hepatic)
Mechanical
Neonatal jaundice
Gilbert’s disease
A 59 year old patient is a plant manager. After the tax inspection of his plant he
felt intense pain behind his breastbone irradiating to his left arm. 15 minutes
later his condition came to normal. Which of the possible mechanisms of
stenocardia development is the leading in this case?
High catecholamine concentration in blood
Functional heart overload
Intravascular aggregation of blood corpuscles
Coronary thrombosis
Coronary atherosclerosis
The correct time sequence of changes in acutely ischaemic myocardial cell is :
Immediate beginning of ATP depletion, loss of contractility, further depletion of
ATP, irreversible cells injury
Beginning of ATP depletion, irreversible cell injury, loss of contractility
Depletion of ATP, loss of contractility, irreversible cell injury

Irreversible cell injury, ATP depletion, loss of contractility
Intrinsic factor of Castle deficiency causes :
Pernicious anemia
Cooley's anemia
Megaloblastic anemia
Aplastic anemia
Rats being under stress have muscular hypertonia and high arterial pressure,
high glucose concentration in blood and intensified secretion of corticotropin and
corticosteroids. In what stress phase are these animals?
Antishock phase
Erectile
Exhaustion
Terminal
Shock phase
Prothrombin time is increased in :
Willebrand's disease
Afibrinogenemia
Qualitative defect of platelets
Thrombocytopenia
Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-
year-old child developed an autoimmune renal injury. The urine was found with
macromolecular proteins. What process of urine formation was disturbed?
Filtration
Reabsorption
Secretion
Reabsorption and secretion

May 8th

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