Krok 1 Medicine 2005
1. A patient with hypochromic anemia
has splitting and loss of hair, increased
nail brittling and taste alteration. What
is the mechanism of the symptoms
development?
A. Deficiency of iron-containing enzymes
B. Deficiency of vitamin 12
C. Decreased production of parathyrin
D. Deficiency of vitamin А
E. Decreased production of thyroid
hormones
2. A 27- year-old woman has used peni-
cillin containing eye drops. In a few mi-
nutes itching, skin burning, lips and eyeli-
ds edema, whistling cough, decreasing BP
appeared. What antibodies can lead to
this allergic reaction?
A. IgE and IgG
B. IgM and IgG
C. IgA and IgM
D. IgM and IgD
E. IgG and IgD
3. A patient with hypersecretion of the
gastric juices was recomended 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?
A. Stimulation of gastrin production by
G-cells
B. Irritation of taste receptors
C. Irritation of mechanoreceptors of the
oral cavity
D. Irritation of mechanoreceptors of the
stomach
E. Stimulation of excretion of secretin in
the duodenum
4. A journalist’s body temperature has
sharply increased in the morning three
weeks after his mission in India, it
was accompanied with shivering and
bad headache. A few hours later the
temperature decreased. The attacks began
to repeat in a day. He was diagnosed
with tropical malaria. What stage of
development of Plasmodium is infective
for anopheles-female?
A. Gametocytes
B. Shizontes
C. Merozoites
D. Microgamete
E. Sporozoites
5. A 10-year-old child complains of
weakness, nausea, irritability. Helminthes
1
of while color and 5-10 mm long were
found on the underwear. On microscopy
of the scrape from the perianal folds
achromic ovums of unsymmetrical form
were revealed. Indicate what helminth is
parasiting on the child?
A. Enterobins vermicularis
B. Ancylostoma duodenalis
C. Trichuris
D. Trichina
E. Ascaris lumbricoides
6. A patient has been brought to the
hospital with the complaints of headache,
pain in left hypochondrium. He has been
ill for 1,5 weeks. The sudden illness began
with the increase of body temperature up
to 39, 90C. In 3 hours the temperature
decreased and hydropoiesis began. The
attacks repeat rhythmically in 48 hours.
The patient had visited one an Afri-
can country. The doctors have suspected
malaria. What method of laboratory di-
agnostics is necessary to use?
A. Blood examination
B. Immunological tests
C. Stool examination
D. Examination of vaginal and urethral
discharge
E. Urine examination
7. Slime, blood and protozoa 30-200 mi-
crons of length have been revealed in a
man’s feces. The body is covered with ci-
lias and has correct oval form with a li-
ttle bit narrowed forward and wide round
shaped back end. On the forward end a
mouth is visible. In cytoplasm there are
two nucleuses and two short vacuoles. For
whom are the described attributes typi-
cal?
A. Balantidium
B. Lamblia
C. Dysenteric amoeba
D. Trichomonas
E. Intestinal amoeba
8. Galactosemia has been revealed in a
child. Concentration of glucose in the
blood has not considerably changed. What
enzyme deficiency caused this illness?
A. Galactose-1-phosphate uri-
dyltransferase
B. Amylo-1,6-glucosidase
C. Phosphoglucomutase
D. Galactokinase
E. Hexokinase
9. Synthesis of phospholipids is disordered
 Krok 1 Medicine 2005
under the liver fat infiltration. Indicate
which of the following substances can
enhance the process of methylation duri-
ng phospholipids synthesis?
A. Methionine
B. Ascorbic acid
C. Glucose
D. Glycerin
E. Citrate
10. An individual is characterized by
rounded face, broad forehead, a mongoli-
an type of eyelid fold, flattened nasal bri-
dge, permanently open mouth, projecting
lower lip, protruding tongue, short neck,
flat hands, and stubby fingers. What di-
agnosis can be put to the patient?
A. Down’s syndrome
B. Klinefelter’s syndrome
C. Alkaptonuria
D. Supermales
E. Turner’s syndrome
11. 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?
A. Autoimmune inflammation
B. Ischemia of myocardium
C. Resorption of enzymes from necrotized
area of myocardium
D. Secondary infection
E. Vessels ’ thrombosis
12. A patient visited a dentist with
complaints of redness and edema of his
mouth mucous membrane in a month
after dental prosthesis. The patient was
diagnosed with allergic stomatitis. What
type of allergic reaction by Gell and
Cumbs underlies this disease?
A. Delayed type hypersensitivity
B. Cytotoxic
C. Immunocomplex
D. Anaphylactic
E. Stimulating
13. A patient suffering from trombophlebi-
tis of deep veins suddenly died. The
autopsy has shown freely lying red friable
masses with dim crimped surface in the
trunk and bifurcation of the pulmonary
artery. What pathologic process was
revealed by the morbid anatomist?
2
A. Tromboembolism
B. Thrombosis
C. Tissue embolism
D. Embolism with foreign body
E. Fat embolism
14. Purulent endometritis developed in a
woman after delivery. Treating with anti-
biotics inhibitors of murein synthesis was
ineffective. Wide spectrum bactericidal
antibiotic was administered to her. In 6
hours temperature rapidly increased up
to 400 C with shiver. Muscle pains have
appeared. BP dropped down to 70/40
mmHg. Oligura has developed. What is
the main reason for the development of
this condition?
A. Endotoxic shock
B. Toxic effect of preparation
C. Internal bleeding
D. Anaphylactic shock
E. Bacteremia
15. Decreased blood supply to the organs
causes hypoxia that activates fibroblasts
function. Volume of what elements is
increased in this case?
A. Intercellular substance
B. Vessels of microcircular stream
C. Nerve elements
D. Parenchymatous elements of the organ
E. Lymphatic vessels
16. Methotrexate (structural analogue
of the folic acid which is competitive
inhibitor of the dihydrofolatreductase)
is prescribed for treatment of the mali-
gnant tumour. On which level does
methotrexate hinder synthesis of the
nucleic acids?
A. Mononucleotide synthesis
B. Replication
C. Transcription
D. Reparation
E. Processing
17. A 2-year-old child experienced
convulsions because of lowering calcium
ions concentration in the blood plasma.
Function of what structure is decreased?
A. Parathyroid glands
B. Hypophysis
C. Adrenal cortex
D. Pineal gland
E. Thymus
18. From the nasopharynx of a 5-year-old
child a microorganism was excreted which
is identical to Corynebacterium diphtheri-
 Krok 1 Medicine 2005
ae dose according to morphological and
biochemical signs. Microorganism does
not produce exotoxin. As a result of what
process can this microorganism become
toxigenic?
A. Phage conversion
B. Cultivation in the telluric environment
C. Passing through the organism of the
sensative animals
D. Growing with antitoxic serum
E. Chromosome mutation
19. A patient with encephalopathy was
admitted to neurological department.
Correlation of increasing encephalopathy
and substances absorbed by the
bloodstream from the intestines was
revealed. What substances created in the
intestines can cause endotoxemia?
A. Indole
B. Butyrate
C. Acetacetate
D. Biotin
E. Ornithine
20. A 50-year-old man has felt vague
abdominal discomfort within past 4
months. Physical examination revealed
no lymphadenopathy, and no abdomi-
nal masses or organomegaly at palpation.
Bowel sounds are heard. An abdominal
CT scan shows a 20 cm retroperitoneal
soft tissue mass obscuring the left psoas
muscle. A stool specimen tested for occult
blood is negative. Which of the following
neoplasms is this man most likely to have?
A. Lipoma
B. Melanoma
C. Hamartoma
D. Adenocarcinoma
E. Lymphoma
21. A 40-year-old woman has had a feeli-
ng of abdominal discomfort for the past
8 months. On pelvic examination, there is
the right adnexal mass. Abdominal CT
scan demonstrates a 7 cm cystic mass
involving the right ovary with small areas
of calcification. The uterus is normal in
size. The right fallopian tube and ovary
have been removed surgically. Grossly,
the mass on sectioning is filled with
abundant hair and sebum. Microscopi-
cally, the mass has glandular spaces li-
ned by columnar epithelium, squamous
epithelium with hair follicles, cartilage,
and dense connective tissue. What type
of tumour is it?
3
A. Teratoma
B. Squamous cell carcinoma of ovary
C. Melanoma
D. Sarcoma of ovary
E. Metastase of cervical carcinoma
22. A man died 8 days after the beginni-
ng of the disease. He was diagnosed with
dysentery. At the autopsy it was found out
a thickened wall of the sigma and rectum,
fibrinous membrane on the surface of
mucous membrane. Histologically: there
is a deep necrosis of mucous membrane
with infiltration of necrotic masses with fi-
brin. What kind of colitis does correspond
to the changes?
A. Diphtheritic
B. Catarrhal
C. Ulcerative
D. Chronic
E. Gangrenous
23. A patient has undergone an amputati-
on of lower extremity. Some time later
painful nodules appeared in a stump.
Amputatious neuromas were found out
at the microscopic examination. To what
pathological processes do those formati-
ons relate?
A. Regeneration
B. Dystrophy
C. Inflammation
D. Hyperemia
E. Metaplasia
24. During the fetal period of the
development in the vascular system of
the fetus a large arterial (Botallo’s)
duct is functioning which converts into
lig.arteriosum after birth. What anatomi-
cal formations does this duct connect?
A. Pulmonary trunk and aorta
B. Right and left auricle
C. Aorta and inferior vena cava
D. Pulmonary trunk and superior vena
cava
E. Aorta and superior vena cava
25. A 22-year-old patient was admitted
to the hospital with complaints of heavy
nasal breathing. During the examination
of her nasal cavity the doctors found thi-
ckened mucous membrane, a lot of mucus
and nodular infiltrates without erosions
in the nose.The nasal rhinoscleroma was
diagnosed. The biopsy was taken. What
typical morphological changes may be
found?
 Krok 1 Medicine 2005
A. Granulomas with Mikulicz’s cells
B. Granulomas with Virchow’s cells
C. Granulomas with Langhan’s cells
D. Granulomas with foreign body cells
E. Interstitial inflammation
26. A woman suffering from dysfuncti-
onal metrorrhagia was made a diagnostic
abortion. Histologically in the scrape
there were a lot of small stamped
glandulars covered with multirowed epi-
thelium. The lumens of some glandulars
were cystically extended. Choose the vari-
ant of general pathologic process in the
endometrium.
A. Glandular-cystic hyperplasia of
endometrium
B. Atrophy of endometrium
C. Metaplasia of endometrium
D. Neoplasm of endometrium
E. Hypertrophic growth
27. A 60-year-old patient was hospitali-
sed to the surgical department because
of infection caused by blue pus baci-
llus (Pseudomonas aeruginosa) which is
sensative to penicillin antibiotics. Indicate
which of the given penicillins has marked
activity to the Pseudomonas aeruginosa?
A. Carbenicillin disodium
B. Benzylpenicillin
C. Phenoxymethylpenicillin
D. Oxacillin
E. Methicillin
28. A 45-year-old woman suffers from
allergic seasonal coryza caused by the
ambrosia blossoming. What adipose cells
group stabilizer medicine can be used for
prevention of this disease?
A. Ketotifen
B. Diazoline
C. Phencarol
D. Tavegyl
E. Dimedrol
29. A lung of a premature infant
is presented on electronic photomi-
crography 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?
A. Alveocytes type II
B. Alveocytes type I
C. Alveolar macrophages
D. Secretory cells
E. Fibroblasts
30. A young man felt sharp pain in the
4
back during active tightening on the hori-
zontal bar. Objectively: pain while movi-
ng upper extremity, limited pronation
and adduction functions. Sprain of what
muscle can be observed here?
A. М.latissimus dorsi
B. М.levator scapulae
C. М.romboideus major
D. М.trapezius
E. М.subscapularis
31. The alternate usage of dichloti-
azide, etacrin acid and lasex did not
cause marked diuretic effect in the
patient with marked peripheral edema.
The aldosterone level in the blood is
increased. Indicate which medicine should
be prescribed:
A. Spironolacton
B. Mannit
C. Clopamid
D. Urea
E. Amilorid
32. A 46 year-old man complains of di-
fficult nose breathing. Mikulich cells,
storage of epithelioid cells, plasmocytes,
lymphocytes, hyaline balls are discovered
in the biopsy material of the nose thi-
ckening. What is the most likely di-
agnosis?
A. Scleroma
B. Virus rhinitis
C. Allergic rhinitis
D. Rhinovirus infection
E. Meningococcal nasopharyngitis
33. A 56-year-old patient complaining
of thirst and frequent urination was di-
agnosed with diabete mellitus. Butamin
was prescribed. How does the medicine
act?
A. It stimulates β-cells of Langergans’
islets
B. It helps to absorb the glucose by the
cells of the organism tissues
C. It relieves transport of glucose through
the cells’ membranes
D. It inhibits α-cells of Langergans’ islets
E. It inhibits absorption of glucose in the
intestines
34. During the breakout of acute respi-
ratory infection in order to diagnose
influenza the express-diagnosis, based
on revealing of specific viral antigen in
the examined material (nasopharyngial
lavage), is carried out. Which reaction is
used for this?
 Krok 1 Medicine 2005 5

membrane of what part of the stomach

A. Immunofluorescence was studied?
B. Complement binding
C. Agglutination A. Pyloric part
D. Precipitation B. Fundus of stomach
E. Opsonization C. Cardia
D. Body of stomach
35. A patient with clinical signs E. -
of immunodeficiency has unchanged
number and functional activity of 40. Live vaccine is injected into the human
T and B lymphocytes. Dysfunction’s body. Increasing activity of what cells of
defect of antigen-presentation to the connective tissue can be expected?
immunocompetent cells was found duri-
ng investigation on the molecule level. A. Plasmocytes and lymphocytes
Defect of what cells is the most probable B. Macrophages and fibroblasts
here? C. Pigmentocytes and pericytes
D. Adipocytes and adventitious cells
A. Macrophages, monocytes E. Fibroblasts and labrocytes
B. Т-lymphocytes, В-lymphocytes
C. NK-cells 41. When a patient with traumatic impai-
D. Fibroblasts, Т-lymphocytes, В- rment of the brain was examined, it was
lymphocytes discovered that he had stopped to di-
E. 0-lymphocytes stinguish displacement of an object on
the skin. What part of the brain was
36. The action of electric current on the damaged?
exitable cell caused depolarization of
its membrane. Movement of what ions A. Posterior central gurus
through the membrane caused depolari- B. Occipital zone of the cortex
sation? C. Parietal zone of the cortex
D. Frontal central gurus
A. Na+ E. Frontal zone
B. −
3
C. 2+ 42. In the blood of a 26-year-old man
D. l− 18% of erythrocytes of the spherical, ball-
E. + shaped, flat and thorn-like shape have
been revealed. Other eritrocytes were in
37. Electrocardiogram of a 45-year-old the form of the concavo-concave disks.
man showed absence of P-wave in all the How is this phenomenon called?
leads. What part of the conducting system
is blocked? A. Physiological poikilocytosis
B. Pathological poikilocytosis
A. Sinu-atrial node C. Physiological anisocytosis
B. Atrioventricular node D. Pathological anisocytosis
C. Common branch of the bundle of His E. Erytrocytosis
D. Branches of the bundle of His
E. Purkinje’s fibres 43. In case of enterobiasis acrihine - the
structural analogue of vitamin B2 - is
38. The alveolar ventilation of the pati- administered. The synthesis disorder of
ent is 5 L/min, the breath frequency is 10 which enzymes does this medicine cause
per/min, and the tidal volume is 700 ml. in microorganisms?
What is the patient’s dead space ventilati-
on? A. FAD-dependent dehydrogenases
B. Cytochromeoxidases
A. 2,0 L/min C. Peptidases
B. 0,7 L/min D. NAD-dependet dehydrogenases
C. 1,0 L/min E. Aminotransferases
D. 4,3 L/min
E. - 44. When the pH level of the stomach
lumen decreases to less than 3, the antrum
39. During histological examination of of the stomach releases peptide that acts
the stomach it was found out that glands in paracrine fashion to inhibit gastrin
contained very small amount of pariental release. This peptide is:
cells or they were totally absent. Mucose
 Krok 1 Medicine 2005 6

A. GIF The patient has acidosis. Point substances,

B. Acetylcholine which accumulation in the blood results in
C. Gastrin-releasing peptide (GRP) these manifestations:
D. Somatostatin
E. Vasoactive intestinal peptide (VIP) A. Ketone bodies
B. Amino acids
45. Different functional groups can be C. Monosaccharides
presented in the structure of L-amino aci- D. High fatty acids
d’s radicals. Identify the group that is able E. Cholesterol esters
to form ester bond:
51. Only one factor can influence the
A. -OH charge of amino acid radicals in the active
B. -SH centre of enzyme. Name this factor:
C. -CONH2
D. -CH3 A. pH medium
E. -NH2 B. Pressure
C. Temperature
46. The conjugated protein necessarily D. The presence of a competitive inhibitor
contains special component as a non- E. The surplus of a product
protein part. Choose the substance that
can’t carry out this function: 52. The high level of Lactate
Dehydrogenase (LDH) isozymes
A. HNO3 concentration showed the increase of
B. АТP LDH-1 and LDH-2 in a patient’s blood
C. Thiamine pyrophosphate plasma. Point out the most probable di-
D. AMP agnosis:
E. Glucose
A. Myocardial infarction
47. A denaturation of proteins can be B. Skeletal muscle dystrophy
found in some substances. Specify the C. Diabetes mellitus
substance that is used for the incomplete D. Viral hepatitis
denaturation of hemoglobin: E. Acute pancreatitis
A. Urea 53. Succinate dehydrogenase catalyses the
B. Toluene dehydrogenation of succinate. Malonic
C. Sulfuric acid acid HOOC − CH2 − COOH is used
D. Nitric acid to interrupt the action of this enzyme.
E. Sodium hydroxide Choose the inhibition type:
48. Moving of the daughter chromatids to A. Competitive
the poles of the cell is observed in the mi- B. Allosteric
totically dividing cell. On what stage of C. Non-competitive
the mitotic cycle is this cell? D. Limited proteolysis
E. Dephosphorylation
A. Anaphase
B. Metaphase 54. Pyruvate concentration in the patient’s
C. Telophase urine has increased 10 times from normal
D. Prophase amount. What vitamin deficiency can be
E. Interfase the reason of this change:
49. Nowadays about 50 minor bases have A. Vitamin B1
been found in the t-RNA structure besi- B. Vitamin C
des the main four nitrogenous bases. C. Vitamin A
Choose the minor nitrogenous base: D. Vitamin E
E. Vitamin B6
A. Dihydrouracil
B. Uracil 55. Hydroxylation of endogenous
C. Cysteine substrates and xenobiotics requires a
D. Adenine donor of protons. Which of the followi-
E. Cytosine ng vitamins can play this role?
50. The patient with diabetes mellitus has
been delivered in hospital in the state of
unconsciousness. Arterial pressure is low.
 Krok 1 Medicine 2005
A. Vitamin C
B. Vitamin P
C. Vitamin B6
D. Vitamin E
E. Vitamin A
56. The gluconeogenesis is activated in
the liver after intensive physical trai-
nings .What substance is utilized in
gluconeogenesis first of all in this case:
A. Lactate
B. Pyruvate
C. Glucose
D. Glutamate
E. Alanine
57. The formation of a secondary mediator
is obligatory in membrane-intracellular
mechanism of hormone action. Point
out the substance that is unable to be a
secondary mediator:
A. Glycerol
B. Diacylglycerol
C. Inositol-3,4,5-triphosphate
D. CAMP
E. Ca2+
58. There is only one hormone among the
neurohormones which refers to the deri-
vatives of amino acids according to classi-
fication. Point it out:
A. Melatonin
B. Thyroliberin
C. Vasopressin
D. Oxytocin
E. Somatotropin
59. A patient with complaints of 3-day-
long fever, general weakness, loss of
appetite came to visit the infectionist.
The doctor suspected enteric fever. Which
method of laboratory diagnosis is the best
to confirm the diagnosis?
A. Detachment of blood culture
B. Detachment of myeloculture
C. Detachment of feces culture
D. Detachment of urine culture
E. Detachment of pure culture
60. A consumptive patient has an open
pulmonary form of disease. Choose what
sputum staining should be selected for fi-
nding out the tubercle (Koch’s) bacillus?
A. Method of Ziel-Neelsen
B. Method of Romanowsky-Giemsa
C. Method of Gram
D. Method of Neisser
E. Method of Burry-Gins
7
61. During surgical operation a blood
transfusion was made. The blood must be
checked to find antigens of some disease.
What disease is expected to be found?
A. Virus of hepatitis B
B. Virus of hepatitis A
C. Adenovirus
D. Enterovirus
E. Virus of hepatitis E
62. A person has steady HR not exceedi-
ng 40 bpm. What is the pacemaker of the
heart rhythm in this person?
A. Atrioventricular node
B. Sinoatrial node
C. His’ bundle
D. Branches of His’ bundle
E. Purkinye’ fibers
63. The sterile Petri dishes and pipettes
are necessary to prepare for microbi-
ological tests in bacteriological laboratory.
What way of sterilization should be appli-
ed in this case?
A. Dry-heat sterilization
B. Tyndallization
C. Pasteurization
D. Steam sterilization in autoclave
E. Boiling
64. A 50-year-old male farm worker has
been brought to the emergency room. He
was found confused in the orchard and si-
nce then has remained unconscious. His
heart rate is 45 and his blood pressure is
80/40 mm Hg. He is sweating and sali-
vating profusely. Which of the following
should be prescribed?
A. Atropine
B. Norepinephrine
C. Proserine
D. Physostigmine
E. Pentamine
65. A 58-year-old female has undergone
surgery for necrotic bowel. Despi-
te having been treated with antibi-
otics, on postoperative day 5, she
develops symptoms (fever, hypotension,
tachycardia, declining urine output, and
confusion) consistent with septic shock.
What hemodynamic support would be
helpful?
 Krok 1 Medicine 2005
A. Fluids and Dobutamine infusion
B. Dobutamine infusion
C. Antibiotic administration
D. Fluid administration
E. Atropine administration
66. A 42-year-old man who has been
injured in a car accident is brought into
the emergency room. His blood alcohol
level on admission is 250 mg/dL. Hospital
records show a prior hospitalization for
alcohol related seizures. His wife confi-
rms that he has been drinking heavily
for 3 weeks. What treatment should be
provided to the patient if he goes into wi-
thdrawal?
A. Diazepam
B. Phenobarbital
C. Pentobarbital
D. Phenytoin
E. None
67. A 13-year-old girl with history of
asthma complained of cough, dyspnea
and wheezing. Her symptoms became
so severe that her parents brought her
to the emergency room. Physical exami-
nation revealed diaphoresis, dyspnea,
tachycardia and tachypnea. Her respi-
ratory rate was 42/min, pulse rate was 110
beats per minute, and blood pressure was
130/70 mm Hg. Choose from the following
list the most appropriate drug to reverse
the bronchoconstriction rapidly:
A. Salbutamol
B. Cromolyn
C. Beclomethasone
D. Methylprednidsolone
E. Ipratropium
68. A doctor administered Allopurinol
to a 26-year-old young man with the
symptoms of gout. What pharmacological
action of Allopurinol ensures therapeuti-
cal effect?
A. By inhibiting uric acid synthesis
B. By increasing uric acid excretion
C. By inhibiting leucocyte migration into
the joint
D. By general anti-inflammatory effect
E. By general analgetic effect
69. A patient who came to the doctor
because of his infertility was admini-
stered to make tests for toxoplasmosis
and chronic gonorrhoea. Which reacti-
on should be performed to reveal latent
toxoplasmosis and chronic gonorrhoea of
the patient?
8
A. (R)CFT- Reiter’s complement fixation
test
B. IFA - Immunofluorescence assay
C. Immunoblot analysis
D. RDHA - Reverse direct hemaggluti-
nation assay
E. RIHA - Reverse indirect hemaggluti-
nation assay
70. Some diseases reveal symptoms of
aldosteronism with hypertension and
edema due to sodium retention in the
organism. What organ of the internal
secretion is affected on aldosteronism?
A. Adrenal glands
B. Testicle
C. Ovaries
D. Pancreas
E. Hypophysis
71. A patient had been taking glucocorti-
coids for a long time. When the
preparation was withdrawn he developed
the symptoms of disease aggravation,
decreased blood pressure and weakness.
What is the reason of this condition?
A. Appearance of adrenal insufficiency
B. Hyperproduction of ACTH
C. Sensibilization
D. Habituation
E. Cumulation
72. A patient after hypertension stroke
does not have voluntary movements in
his right arm and leg with the increased
muscle tone in these extremites. What
type of disfunction of nervous system is
it?
A. Central paralysis
B. Peripheral paralysis
C. Peripheral paresis
D. Reflex paresis
E. Central paresis
73. A patient, who suffers from congeni-
tal erythropoietic porphyria, has skin
photosensitivity. The accumulation of
what compound in the skin can cause it?
A. Uroporphyrinogen 1
B. Protoporphyrin
C. Uroporphyrinogen 2
D. Coproporphyrinogen 3
E. Heme
74. A patient has a malignisation
of thoracic part of esophagus. What
lymphatic nodes are regional for this
organ?
 Krok 1 Medicine 2005
A. Anulus lymphaticus cardiae
B. Nodi lymphatici paratrachealis
C. Nodi lymphatici prevertebralis
D. Nodi lymphatici pericardiales laterales
E. Nodi lymphatici mediastinales posteri-
ores
75. A sick man with high temperature and
a lot of tiny wounds on the body has been
admitted to the hospital. Lice have been
found in the folds of his clothing. What
disease can be suspected in the patient?
A. Epidemic typhus
B. Tularemia
C. Scabies
D. Malaria
E. Plague
76. A patient with suspicion on epidemic
typhus was admitted to the hospital. Some
arachnids and insects have been found in
his flat. Which of them may be a carrier of
the pathogen of epidemic typhus?
A. Lice
B. Spiders
C. Bed-bugs
D. Cockroaches
E. Houseflies
77. A businessman came to India from
South America. On examination the
physician found that the patient was
suffering from sleeping-sickness. What
was the way of invasion?
A. As a result of bug’s bites
B. As a result of mosquito’s bites
C. With contaminated fruits and vegetables
D. Through dirty hands
E. After contact with a sick dogs
78. The patient has come to the hospital
from the smelting workshop in the condi-
tion of hyperthermia. What is the direct
cause of loss of consciousness at the heat
stroke?
A. Decreased brain blood supply
B. Arterial pressure drop
C. Increased water loss through sweating
D. Decrease of heart output
E. Dilatation of peripheral vessels
79. There is an inhibited coagulation in
the patients with bile ducts obstruction,
bleeding due to the low level of absorbti-
on of a vitamin. What vitamin is in defici-
ency?
9
A. К
B. А
C. D
D. Е
E. Carotene
80. Blood analysis of a patient showed si-
gns of HIV infection (human immunodefi-
ciency virus). Which cells does HIV-virus
primarily affect?
A. Cells that contain receptor T4 (T-
helpers)
B. Cells that contain receptor IgM (B-
lymphocytes)
C. Specialized nervous cells (neurons)
D. Mast cells
E. Proliferating cells (stem hematoplastic
cells)
81. The preventive radioprotector was
given to a worker of a nuclear power
station. What mechanism from the below
mentioned is considered to be the main
mechanism of radioprotection?
A. Inhibition of free radicals formation
B. Prevention of tissue’s hypoxia
C. Activation of oxidation reactions
D. Increasing of tissue blood supply
E. Increasing of respiration
82. The pulmonalis embolism has
suddenly developed in a 40 year-old
patient with opened fracture of the hip.
Choose the possible kind of embolism.
A. Fat
B. Thrombus-embolus
C. Air
D. Tissue
E. Foreign body
83. A 52 year-old patient with bronchi-
al asthma was treated with glucocorticoi-
ds. Fever reaction appeared as a result
of postinjective abscess. The patient
had subfebrile temperature, which didn’t
correspond to latitude and severity of
inflammatory process. Why did patient
have low fever reaction?
A. Inhibited endogen pyrogens production
B. Violation of heat loss through lungs
C. Inflammatory barrier formation in
injection place
D. Violation of heat-producing mechani-
sms
E. Thermoregulation center inhibition
84. Patient 54 year-old, 5th day
after surgical operation. Blood count:
 Krok 1 Medicine 2005
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: ani-
zocytosis, poikilocytosis, reticulocytes-
3,8%. What anemia does this patient
have?
A. Acute posthemorragic anemia
B. Acquired hemolytic anemia
C. Anemia from iron deficiency
D. Hypoplastic anemia
E. Chronic posthemorragic anemia
85. A patient’s blood was analyzed and
the decreased erythrocyte’s sedimentation
rate (ESR) was discovered. What disease
from the listed below is accompanied with
decreased ESR?
A. Polycytemia
B. Hepatitis
C. Splenomegaly
D. Vitamin B deficiency
E. Myocardial infarction
86. X-ray examination discovered lungs
emphysema in the patient. What is the
reason of short breath development in this
case?
A. Decreased lungs elasticity
B. Increased lungs elasticity
C. Inhibition of respiratory center
D. Excitation of respiratory center
E. Decreasing of alveoli receptors sensiti-
vity
87. The patient with pneumonia was
treated with antibiotics for a long peri-
od. After treatment patient complains of
frequent and watery stool, abdomenal
pain. What is the reason of intestine
function disorder?
A. Intestinal disbacteriosis development
B. Antibiotics toxic influence on the GIT
C. Autoimmune reaction development
D. Bacteria toxins influence
E. Hereditary enzyme defect
88. A 16 year-old patient got numerous
traumas in automobile accident. Now the
patient is haning a shock. АP - 80/60 mm
Hg. daily urine volume 60-80 ml. What
pathogenic mechanism leads to kidneys
function violation?
10
A. Decreased hydrostatic pressure in
glomerular capillaries
B. Increased osmotic pressure in
glomerular capillaries
C. Increased pressure in Bowman’s capsule
D. Increased vasopressin blood
concentration
E. Trauma of the urinary bladder
89. A 46 year-old patient has complai-
ned of headache, fatigue, thirst, pains
in the spine and joints for the last 2
years. Clinically observed disproportional
enlargement of hands, feet, nose, superci-
liary arches. He notes that he needed
to buy bigger shoes three times. What
is the main reason of such disproporti-
onal enlargement of different parts of the
body?
A. Cartilaginous tissue proliferation under
growth hormone influence
B. Increased sensitivity of the tissues to
growth hormone
C. Joints dystrophy development
D. Increased sensitivity of the tissues to
insulin
E. Joints chronic inflammation
development
90. A 55-year-old patien was hospitali-
zed in result of the trauma of the medial
group of femoral muscles. What kind of
movements is the patient unable to do?
A. Adduction of femur
B. Abduction of femur
C. Flexion of femur
D. Extension of femur
E. Suppination of femur
91. A mother of a newborn complai-
ns of her baby’s constant belching with
undigested milk. Which developmental
anomaly is it an evidence of?
A. Esophageal atresia
B. Labium leporium
C. Faux lupinum
D. Anal atresia
E. Esophageal fistula
92. During the endoscopy the inflammati-
on of a major papilla of the duodenum
and the disturbances of bile secretion
were found. In which part of duodenum
were the problems found?
 Krok 1 Medicine 2005
A. Descendent part
B. Ascendant part
C. Bulb
D. Upper horizontal part
E. Lower horizontal part
93. A 18-year-old patient came to the out-
patient department with the complaints
of bleeding trauma in the vestibule of
his nose. On examination: the mechanical
injure of the mucous layer of the vesti-
bule without continuation into nasal cavi-
ty proper. What is the boundary between
the vestibule and nasal cavity proper?
A. Nasal limen
B. Nasal roller
C. Nasal septa
D. Choanes
E. Nostrils
94. A 32-year-old patient has been di-
agnosed with bartholinitis (inflammation
of Bartholin’s glands ). In what part of the
female urogenital system are the Bartholi-
n’s glands located?
A. The labia major
B. The labia minor
C. The clitoris
D. The vagina
E. The uterus
95. A 50 year-old patien was injured on
the occipital region of the head. The
closed skull’s 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?
A. The cerebellum
B. The medulla oblongata
C. The mind-brain
D. The inter-brain
E. The spinal cord
96. A 50 year-old patient had hemorrhage
of the brain and was taken to the hospital.
The place of hemorrhage was revealed on
the lateral hemispheres surfaces during
the medical examination. What artety was
injured ?
A. The middle cerebral artery
B. The anterior cerebral artery
C. The posterior cerebral artery
D. The anterior communicating artery
E. The posterior communicating artery
97. A 30-year-old patient was hospitalized
due to bleeding of the facial artery . What
place on the face has to be pressed to stop
11
bleeding?
A. The mandible’s edge
B. The mental process
C. The mandible’s branch
D. The nose’s back
E. The molar bone
98. A 19 year-old patient was diagnosed
with appendicitis and was hospitali-
zed. The surgical operation on ablating
appendix vermiformis is to be performed.
What artery must be fixed to stop bleedi-
ng during the surgical operation?
A. The ileocolic artery
B. The colica dextra
C. The colica media
D. The colica sinistra
E. The iliac
99. An autopsy has revealed that kidneys
are enlarged, surface is large-granular
because of multiple cavities with smooth
wall, which are filled with clear fluid. What
kidney disease did the patient have?
A. Polycystic kidney
B. Necrotic nephrosis
C. Pyelonephritis
D. Glomerulonephritis
E. Infarction
100. An old woman was hospitalized with
acute pain, edema in the right hip joint;
the movements in the joint are limited.
Which bone or part of it was broken?
A. The neck of the thigh
B. The body of the thigh bone
C. Condyle of the thigh
D. Pubic bone
E. Ischial bone
101. A 45-year-old man fell on the ri-
ght knee and felt the acute pain in the
joint. On examination: severe edema on
the anterior surface of the knee joint.
Crunching sounds are heard while moving
the joint. Which bone is destroyed?
A. Knee-cap
B. Neck of the thigh bone
C. Left epicondyle of the thigh
D. Right epicondyle of the thigh
E. Head of the thigh bone
102. During the operation on the hip joi-
nt of a 5-year-old child her ligament was
damaged which caused bleeding.What li-
gament was damaged?
 Krok 1 Medicine 2005
A. The head of the thigh
B. Perpendicular of the acetabule
C. Iliofemoral
D. Pubofemoral
E. Ischiofemoral
103. A 6-year-old child fell on the cutti-
ng object and traumatized soft tissues
between tibia and fibula . What kind of
bone connection was injured?
A. Membrane
B. Suture
C. Ligament
D. Fontanel
E. Gomphosis
104. An autopsy revealed: soft arachnoid
membrane of the upper parts of cerebral
hemisphere is plethoric, of yellowish-
green color, soaked with purulent and
fibrose exudate, it lookes like a cap.
What disease is characterised by these
symtoms?
A. Meningococcal meningitis
B. Tuberculous meningitis
C. Influenza meningitis
D. Meningitis at anthrax
E. Meningitis at typhus
105. Usually the intravenous injection is
done into median cubital vein because it
is slightly movable due to fixation by the
soft tissues. What does it fix in the cubital
fossa?
A. Aponeurosis of biceps muscle
B. Tendon of the triceps muscle
C. Brachial muscle
D. Brachioradial muscle
E. Anconeus muscle
106. A 55-year-old patient with continuing
ventricular arrhythmias was admitted to
the hospital. The patient is taking timolol
drops for glaucoma, daily insulin injecti-
ons for diabetes mellitus, and an ACE
inhibitor for hypertension. You have deci-
ded to use phenytoin instead of procai-
namide. What is the reason?
A. The anticholinergic effect of procai-
namide would aggravate glaucoma
B. The local anesthetic effect of procai-
namide would potentiate diabetes
C. The hypertensive effects of procainami-
de would aggravate the hypertension
D. The local anesthetic effect of procai-
namide would aggravate the hypertension
E. The cholinergic effects of procainamide
would aggravate the diabetes
12
107. A 35-year-old man under the
treatment for pulmonary tuberculosis has
acute-onset of right big toe pain, swelling,
and low-grade fever. The gouty arthritis
was diagnosed and high serum uric acid
level was found. Which of the followi-
ng antituberculosis drugs are known for
causing high uric acid levels?
A. Pyrazinamide
B. Cycloserine
C. Thiacetazone
D. Rifampicin
E. Aminosalicylic acid
108. A person was selling "homemade
pork"sausages on the market. State sani-
tary inspector suspected falcification of
the sausages. What serological immune
reaction can identifiy food substance?
A. Precipitation test
B. Indirect hemagglutination test
C. Agglutination test
D. Immunofluorescence test
E. Complement- fixation test
109. A 25-year-old woman with red and
itchy eczematoid dermatitis visits your
office. She had a dental procedure one
day earlier with administration of a local
anesthetic. There were no other findings,
although she indicated that she had a hi-
story of allergic reactions. Which of the
following drugs is most likely involved?
A. Procaine
B. Cocaine
C. Lidocaine
D. Bupivacaine
E. Etidocaine
110. The CNS stimulation produced by
methylxanthines, such as caffeine, is most
likely due to the antagonism of one of the
following receptors:
A. Adenosine receptors
B. Glycine receptors
C. Glutamate receptors
D. GABA receptors
E. Cholinergic muscarinic receptors
111. A patient has elbow joint trauma
with avulsion of medial epicondyle of
humerus. What nerve can be damaged in
this trauma?
A. Ulnar
B. Radial
C. Musculocutaneous nerve
D. Cardiac cutaneous nerve
E. Medial cutaneous nerve of forearm
 Krok 1 Medicine 2005
112. A student is thoroughly summarisi-
ng a lecture. When his groupmates begin
talking the quality of the summarising
worsens greatly. What type of inhibition
in the cerebral cortex is the cause of it?
A. External
B. Protective
C. Dying
D. Differential
E. Delayed
113. While enrolling a child to school
Mantu’s test was made to define whether
revaccination was needed. The test result
is negative. What does this test result
mean?
A. Absence of cell immunity to the
tuberculosis
B. Presence of cell immunity to the
tuberculosis
C. Absence of antibodies for tubercle
bacillus
D. Absence of antitoxic immunity to the
tuberculosis
E. Presence of antibodies for tubercle
bacillus
114. The donor who had not donated the
blood for a long time was examined with
IFA method. Anti-HBs antibodies were
revealed. What does positive result of IFA
in this case mean?
A. Previous hepatitis B
B. Acute hepatitis B
C. Acute hepatitis C
D. Chronic hepatitis В
E. Chronic hepatitis С
115. Inhibition of alpha-motoneuron of
the extensor muscles was noticed after sti-
mulation of α-motoneuron of the flexor
muscles during the experiment on the spi-
nal column. What type of inhibition can
be caused by this process?
A. Reciprocal
B. Presynaptic
C. Depolarizational
D. Recurrent
E. Lateral
116. A worker has decreased buffer
capacity of blood due to exhausting
muscular work The influx of what acid
substance in the blood can cause this
symptom?
13
A. Lactate
B. Pyruvate
C. 1,3-bisphosphoglycerate
D. α-ketoglutarate
E. 3-phosphoglycerate
117. Substitution of the glutamic acid on
valine was revealed while examining initi-
al molecular structure. For what inherited
pathology is this symptom typical?
A. Sickle-cell anemia
B. Thalassemia
C. Minkowsky-Shauffard disease
D. Favism
E. Hemoglobinosis
118. Inflamation is characterised by
increasing penetration of vessels of mi-
crocirculation stream, increasing of their
fluid dynamic blood pressure. Increasing
of the osmotic concentration and dispersi-
ty of protein structures can be found in the
intercellular fluid. What kind of edema are
to be observed in this case?
A. Mixed
B. Hydrodynamic
C. Colloid-osmotic
D. Lymphogenic
E. Membranogenic
119. Scraps of the mycelium of a fungus,
spores, air bubbles and fat drops were di-
scovered on microscopy of the patient’s
hair excluded from the infected areas.
What fungus disease is characterised by
this microscopic picture?
A. Favus
B. Microspory
C. Trichophytosis
D. Epidermophytosis
E. Sporotrichosis
120. Autopsy of the 58-year-old man hads
revealed that mitral valve is deformed, thi-
ckened, does not totally close. Microscopi-
cally: centers of collagen fibers are eosi-
nophilic, have positive fibrin reaction. The
most probable diagnosis is:
A. Fibrinoid swelling
B. Fibrinoid inflammation
C. Mucoid swelling
D. Hyalinosis
E. Amyloidosis
121. A highly injured person has gradually
died. Please choose the indicator of bi-
ological death:
 Krok 1 Medicine 2005
A. Autolysis and decay in the cells
B. Disarray of chemical processes
C. Loss of consciousness
D. Absence of palpitation and breathing
E. Absence of movements
122. A 37-year-old man was admitted
to the surgical department with the
symptoms of acute pancreatitis: vomiti-
ng, diarrhea, bradycardia, hypotention,
weakness, dehydration of the organism.
What medicine should be used first of all?
A. Contrycal
B. No-spa
C. Platyphylline
D. Etaperazine
E. Ephedrine
123. On autopsy a 35-year-old man the
focus of carnification 5 cm in diametre
enclosed in a thin capsule was revealed in
the second segment of the right lung . The
focus consists of a tough dry friable tissue
with a dim surface. For what disease are
these morphological changes typical?
A. Tuberculoma
B. Lung cancer
C. Chondroma
D. Tumorous form of silicosis
E. Postinflammatory pneumosclerosis
124. A 62-year-old patient was admi-
tted to the neurological department due
to cerebral haemorrage. His conditi-
on is grave. There is evident progressi-
on of deep and frequent breath that
turnes into reduction to apnoea and the
cycle repeates. What respiration type has
developed in the patient?
A. Cheyne-Stockes respiration
B. Kussmaul respiration
C. Biot’s respiration
D. Gasping respiration
E. Apneustic respiration
125. Punctata hemorrhage was found out
in the patient after application of a tourni-
quet. With disfunction of what blood cells
is it connected?
A. Platelets
B. Eosinophiles
C. Monocytes
D. Lymphocytes
E. Neutrophiles
126. In the microspecimen of red bone
marrow multiple capillares were revealed
through the walls of which mature blood
cells penetrated. What type of capillares is
14
it?
A. Sinusoidal
B. Fenestrational
C. Somatical
D. Visceral
E. Lymphatic
127. A 57-year-old patient was admitted
to the gastroenterological department wi-
th suspicion of Zollinger-Ellison syndrom
because of rapid increase of gastrin level
in the blood serum. What the most
probable disorder of the secretory functi-
on of the stomach here?
A. Hyperacidity hypersecretion
B. Hyperacidity hyposecretion
C. Achylia
D. Hypoacidity hyposecretion
E. Hypoacidity hypersecretion
128. After breathing with poisonous
steams there is an increased quantity of
slime in respiratory passages of a chemi-
cal production worker. What of respi-
ratory tract epithelial cells participate in
mucousa moistening?
A. Goblet cells
B. Fibroblasts
C. Endocrine cells
D. Langergans cells
E. Intercalated cells
129. A patient suffering from thyrotoxi-
cosis symptoms of vegetoasthenic
syndrome was revealed. What of the
following would show the histological
appearance of a thyroid gland being sti-
mulated by thyroid-stimulating hormone
(TSH)?
A. Columnar-shaped follicular cells
B. Decreased numbers of follicular cells
C. Increased numbers of parafollicular
cells
D. An abundance of colloid in the lumen
of the follicle
E. Decreased numbers of parafollicular
capillaries
130. For a long time a 49-year-old woman
had suffered from glomerulonephri-
tis which caused death. The autopsy
revealed that the size of her kidneys
was 7х3х2,5 sm, weight 65,0 g, they were
dense and small-grained. Microscopi-
cally: fibrinogenous inflammation of
serous and mucous capsules, dystrophic
changes of parenchymatous organs, brain
edema. What complication can cause such
changes of serous capsules and inner
 Krok 1 Medicine 2005 15

organs? woman is healthy and there were no cases

of hemophilia in her family. What is the
A. Uraemia risk of having a sick child in this family?
B. Anemia
C. Sepsis A. 0
D. DIC-syndrome B. 100%
E. Thrombopenia C. 75%
D. 50%
131. The reason of occurrence of some di- E. 25%
seases of an oral cavity is connected wi-
th structural peculiarities of its mucous 136. Oval and round organelles with
membrane. What morphological attri- double wall are seen at the electron mi-
butes characterize these features? crograph. The outer membrane is smooth,
the inner membrane folded into cristae
A. No muscularis mucosa, stratified contain enzyme ATPase synthetase. These
squamous epithelium are:
B. Transitional epithelium, no submucosa
C. Simple columnar ciliated epithelium A. Mitochondria
D. Well developed muscularis, no B. Golgi complex
submucosa C. Lysosomes
E. Transitional epithelium, no muscularis D. Centrioles
mucosa E. Ribosomes
132. There is the change of teeth at 137. A tissue sample of benign tumor was
the 6-8-year-old children: deciduous are studied under the electron microscope.
replaced by permanent. What embrionic A lot of small (15-20 nm) spherical bodi-
tissues are the sources of formation of es, consisting of 2 unequal subunits were
permanent teeth tissues? detected. These are:
A. Ectodermal epithelium of a tooth plate A. Ribosomes
and mesenhime B. Golgi complex
B. Entodermal epithelium of a tooth plate C. Smooth endoplasmic reticulum
and mesenhime D. Microtubules
C. Mesodermal epithelium and mesenhime E. Mitochondria
D. I, II brachial arches
E. Entodermal epithelium and mesoderm 138. A woman who was sick with rubella
during the pregnancy gave birth to a deaf
133. The B cells of endocrine portion child with hare lip and cleft palate. This
of pancreas are selectively damaged by congenital defect is an example of:
alloxan poisoning. How will it be reflected
in blood plasma? A. Phenocopy
B. Edward’s syndrome
A. The content of sugar increases C. Genocopy
B. The content of fibrinogen decrease D. Patau’s syndrome
C. The level of sugar decreases E. Down’s syndrome
D. The content of globulins decreases
E. The content of albumins decreases 139. A woman who was infected with
toxoplasmosis during the pregnancy has a
134. A healthy woman has three sons child with multiple congenital defects.This
affected by color blindness who were born is a result of:
after her two marriages. Children both of
her husbands are healthy. What is the most A. Teratogenesis
possible pattern of inheritance of this di- B. Cancerogenesis
sease? C. Biological mutogenesis
D. Chemical mutogenesis
A. X-linked recessive E. Recombination
B. Y-linked
C. Autosomal recessive 140. At the aboratory experiment
D. Autosomal dominant the eukocyte culture was mixed with
E. X-linked dominant staphylococci. Neutrophile leukocytes
engulfed and digested bacterial cells. This
135. A couple came for medical genetic processes are termed:
counseling. The man has hemophilia, the
 Krok 1 Medicine 2005
A. Phagocytosis
B. Pinocytosis
C. Diffusion
D. Facilitated diffusion
E. Osmosis
141. Marked increase of activity of МВ-
forms of CPK (creatinephosphokinase)
and LDH-1 was revealed by examination
of the patient’s blood. What is the most
probable pathology?
A. Miocardial infarction
B. Hepatitis
C. Rheumatism
D. Pancreatitis
E. Cholecystitis
142. An isolated muscle of a frog
is rhythmically irritated with electric
impulses. Every next impulse is in a period
of relaxation from the previus contraction.
What contraction of the muscle occurs?
A. Waved tetanus
B. Single
C. Asynchronous
D. Continuous (smooth) tetanus
E. Tonic
143. M-r S presents all signs of the
hepatic coma: loss of consciousness,
absence of reflexes, cramps, convulsion,
disorder of heart activity, recurrent (peri-
odical) respiration. What are cerebrotoxi-
cal substances which accumulate in blood
under hepar insufficiency?
A. Ammonia
B. IL-1
C. Autoantibody
D. Necrosogenic substances
E. Ketonic body
144. A 16-year-old boy was performed an
appendectomy. He has been hospitalized
for right lower quadrant abdominal pain
within 18 hours. The surgical specimen is
edematous and erythematous. Infiltration
by what of the following cells is the most
typical for the process occuring here?
A. Neutrophils
B. Eosinophils
C. Basophils
D. Limphocytes
E. Monocytes
145. A 19-year-old female suffers from
tachycardia in rest condition, weight loss,
excessive sweating, exophtalmos and irri-
tability. What hormone would you expect
to find elevated in her serum?
16
A. Thyroxine
B. Cortisol
C. Mineralocorticoids
D. ACTH
E. Insulin
146. The concentration of albumins
in human blood sample is lower than
normal. This leads to edema of tissues.
What blood function is damaged?
A. Maintaining the oncotic blood pressure
B. Maintaining the Ph level
C. Maintaining the body temperature
D. Maintaining the blood sedimentation
system
E. All answers are correct
147. A patient with tissue trauma was
taken a blood sample for the determinati-
on of blood clotting parameters. Specify
the right sequence of extrinsic pathway
activation.
A. III – VIIa – Xa
B. III – IV – Xa
C. IV – VIII: TF – Xa
D. IV – VIIa – Xa
E. III – VIII: TF – Xa
148. A patient has been taking a mi-
xture prescribed by neuropathologist for
neurasthenia for two weeks. The patient
feels better but has developed coryza,
conjunctivitis, rash, inertia, decrease of
memory. She is diagnosed with bromizm.
What should be prescribed to decrease the
symptoms?
A. Natrium chloride
B. Glucose solution 5%
C. Asparcam
D. Polyglucin
E. -
149. On autopsy of a still-born infant
abnormalities have been revealed: ventri-
cles are not separated, a single arterial
trunk originates from the right part. For
what class of vertebrates is such heart
construction characteristic?
A. Amphibian
B. Fishes
C. Reptiles
D. Mammals
E. Birds
150. If strong oxidizers get into the
bloodstream, a methemoglobin is formed.
It is a compound, where iron (II) becomes
iron (III). What has to be done to save the
 Krok 1 Medicine 2005
patient?
A. Interchangeable hemotransfusion has
to be done
B. Patient has to be exposed to the fresh
air
C. He has to be calmed down and put to
bed
D. He has to be given pure oxygen
E. Respiratory centers have to be sti-
mulated
151. A 10-year-old child complains of
weakness, nausea, irritability. Helminthes
of white color and 5-10 mm long have
been found on the underwear. On mi-
croscopy of the scrape from the perianal
folds achromic ova of the unsymmetrical
form have been revealed. Which helminth
is in the organism of the child?
A. Enterobins vermicularis
B. Ascaris lumbricoides
C. Ancylostoma duodenalis
D. Trichina
E. Trichuris
152. The low specific gravity of the
secondary urine (1002) was found out in
the sick person. Wat is the most distant
part of nephron where concentration of
secondary urine takes place?
A. In the collecting duck
B. In the nephron’s glomerulus
C. In proximal tubule of nephron
D. In ascending part of loop of Henle
E. In distal tubule of nephron
153. A patient with the symptoms of acute
alcoholic poisoning was brought to the
hospital. What carbohydrates metabolism
changes are typical for this condition?
A. The gluconeogenesis velocity in liver is
decreased
B. The gluconeogenesis is increased in
liver
C. The breakage of glycogen is increased
in liver
D. The anaerobic glucose metabolism
predominates in muscles
E. The anaerobic breakage of glucose is
increased in muscles
154. A 60-year-old patient was diagnosed
with hypothalamic lateral nuclei stroke.
What changes in patient’s behavior may
be expected?
17
A. The rejection of food
B. Aggressive behaviour
C. Depression
D. Thirst
E. Unsatisfied hunger
155. During the experiment on the
influence of chemical substances in the
muscles the reaction of Ca2+ -pump is
weakened. Which phenomenum will be
observed?
A. Prolonged relaxation
B. Prolonged duration of the AP
C. Decreased AP
D. Activation of the sodium-potassium
pump
E. Decreased velocity of the AP distributi-
on
156. The process of heart transplantati-
on determined the viability of myocardi-
al cells. The determination of what
myocardium parameter is the most
important?
A. Rest potential of cardiomyocytes
B. Heart temperature
C. Concentration of oxygen in heart vessels
D. Concentration of calcium-ions in myofi-
brils
E. Concentration of Ca-ions in heart
vessels
157. 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?
A. Decreased rate and force of heart beat
B. Decreased heart beat rate
C. Decreased force of the contraction
D. Heart stops in systole
E. Heart stops in diastole
158. After the trauma, the patient’s right
n.vagus was damaged. Which violation of
the cardiac activity is possible in this case?
A. Violation of the automatism of a Kiss-
Fleck node
B. Violation of the automatism of a atrio-
ventricular node
C. Violation of a conductivity in the right
auricle
D. Block of a conductivity in the atrio-
ventricular node
E. Arrhythmia
159. A 59-year-old man has symptoms
of parenchymatous jaundice and portal
hypertension. Histological examinati-
on of the puncture of the liver bi-
 Krok 1 Medicine 2005
optate has revealed an affected beam-
lobule structure, part of hepatocytes
has signs of fat dystrophy, port-portal
connective tissue septa with formation of
pseudo-lobules, with periportal lympho-
macrophage infiltrations. What is the most
probable diagnosis?
A. Liver cirrhosis
B. Alcohol hepatitis
C. Chronic hepatosis
D. Viral hepatitis
E. Toxic dystrophy
160. A microscopic examination of the
enlarged neck gland of a 14-year-old
girl revealed destruction of the tissue
structure of the node, absence of the
lymph follicles, sclerotic and necrosis
parts. Cell constitution of the node is
polymorphous, lymphocites, eosinophi-
les, atypical cells of the large size wi-
th multiple-lobule nuclei (Beresovsky-
Shternberg cells) and onenucleus large
size cells are observed. What is the most
likely diagnosis?
A. Lymphogranulomatous
B. Acute lympholeucosis
C. Chronic lympholeucosis
D. Berkitt’s lymphoma
E. Fungous mycosis
161. A damage of the atomic power
plant reactor resulted in the run-
out of radioelements. People in the
superstandard radiation zone were radi-
ated with approximately 250-300 r. and
were immediately hospitalized. What
changes in the blood count would be typi-
cal?
A. Lymphopenia
B. Leukopenia
C. Anemia
D. Thrombopenia
E. Neutropenia
162. Obturative jaundice developed in
a 60-year-old patient because of mali-
gnant tumour of the big papillary of the
duodenal. Lumen of what anatomical
structure is squeezed with tumour?
A. Hepatopancreatic ampulla
B. Cystic duct
C. Common hepatic duct
D. Right hepatic duct
E. Left hepatic duct
163. Necrosis focus was observed in the
area of hyperemia and skin edema in
a few hours after burn. What mechani-
18
sm strengthens destructive effects in the
inflammation area?
A. Secondary alteration
B. Primary alteration
C. Emigration of lymphocytes
D. Diapedesis of erythrocytes
E. Proliferation of fibroblasts
164. Analeptical remedy of reflective type
from the H-cholinomimetics group was
given to the patient for restoration of
breathing after poisoning with carbon
monoxide. What medicine was prescribed
to the patient?
A. Lobeline hydrochloride
B. Atropine sulphate
C. Adrenalin hydrochloride
D. Mesaton
E. Pentamin
165. Intrapleural pressure is being
measured in a person. In what phase does
a person hold his breath if the pressure is
- 25 cm H2 O?
A. Forced inspiration
B. Quiet expiration
C. Quiet inspiration
D. Forced expiration
E. -
166. Blood sampling for bulk analysis
is recommended to be performed on an
empty stomack and in the morning. What
changes in blood composition can occur
if to perform blood sampling after food
intake?
A. Increased contents of leukocytes
B. Increased contents of erythrocytes
C. Increased plasma proteins
D. Reduced contents of thrombocytes
E. Reduced contents of erythrocytes
167. Examination of a person revealed
that minute volume of heart is 3500 mL,
systolic volume is 50 mL. What is the
frequency of cardiac contraction?
A. 70 bpm
B. 60 bpm
C. 50 bpm
D. 80 bpm
E. 90 bpm
168. Glomerular filtration rate (GFR)
increased by 20% due to prolonged
starvation of the person. The most evi-
dent cause of filtration changes under this
conditions is:
 Krok 1 Medicine 2005 19

A. Decrease of oncotic pressure of blood A. Inversion

plasma B. Deletion
B. Increase of systemic blood pressure C. Doubling
C. Increase of penetration of the renal D. Translocation
filter E. Replication
D. Increase of filtration coefficient
E. Increase of renal plasma stream 174. A histological spacemen presents
parenchymal organ, which has cortex
169. In the ovary specimen colored with and medulla. Cortex consists of epi-
hematoxylin-eosin, follicle is determined theliocytes bars with blood capillaries
where cubic-shaped follicle epithelium between them; the bars form three zones.
cells are placed in 1-2 layers, and scarlet Medulla consists of chromaffinocytes and
covering is seen around ovocyte. Name venous sinusoids. Which organ has these
this follicle: morphological features?
A. Primary A. Adrenal gland
B. Primordial B. Kidney
C. Secondary C. Lymph node
D. Mature D. Thymus
E. Atretic E. Thyroid
170. A patient complains of frequent and 175. A patient with bronchial asthma
difficult urination. Imperfection of what had been taking tablets which caused
formation can cause it? insomnia, headache, increased blood
pressure. What medecine can cause such
A. Prostate complications?
B. Testicles
C. Bulb-uretic glands A. Ephedrine
D. Testicle adnexa B. Adrenaline
E. Sperm bubbles C. Chromolin sodium
D. Euphyline
171. A 45-year-old man with domestic E. Izadrine
apper arm injuiry came to the trauma
unit. The objective data are: there are no 176. A patient died 3 days after the
extension, adduction or pronation functi- operation because of perforated colon
ons of the arm. What muscle damage with manifestations of diffuse purulent
caused this condition? peritonitis. The autopsy revealed: colon
mucos membrane was thickened and
A. Teres major covered with a fibrin film, isolated
B. Subscapular ulcers penetrated at different depth.
C. Teres minor The histology result: mucous membrane
D. Subspinous necrosis, leukocytes infiltration with
E. Supraspinous hemorrhages focuses. What disease
complication caused the patient’s death?
172. A 68-year-old woman can not move
her upper and lower right extremities A. Dysentery
after stroke. Muscle tone of these extremi- B. Typhoid
ties and reflexes are increased. There are C. Nonspecific ulcerative colitis
pathological reflexes. What form of the D. Crohn’s disease
paralysis is it? E. Amebiasis
A. Hemiplegia 177. Periodic renal colics attacks are
B. Paraplegia observed in a woman with primery
C. Tetraplegia hyperparathyroidizm. Ultrasonic exami-
D. Monoplegia nation revealed small stones in the ki-
E. Dissociation dneys. What is the most plausible reason
of the stones’s formation?
173. Part of the DNA chain turned about
180 degrees due to gamma radiation.
What type of mutation took place in the
DNA chain?
 Krok 1 Medicine 2005
A. Hypercalcemia
B. Hyperphosphatemia
C. Hypercholesterinemia
D. Hyperuricemia
E. Hyperkalemia
178. Ovarian tumour was diagnozed in
a woman. Surgery should be perfomed.
What ligament should be extracted by the
surgeon to disconnect the ovary and the
uterus?
A. The ovarial ligament
B. Broad ligament of uterus
C. Lateral umbilical ligament
D. Suspensory ligament of ovary
E. Round ligament of uterus
179. An intraoperational biopsy of
mammal gland has revealed the si-
gns of atypical tissue with disorder of
parenchyma stroma proportion with
domination of the last, gland structures of
different size and shape, lined with single-
layer proliferative epithelium. What is the
most probable diagnosis?
A. Fibroadenoma
B. Papilloma
C. Noninfiltrative cancer
D. Infiltrative cancer
E. Mastitis
180. The increased intraocular tensi-
on is observed in a patient with
glaucoma.Secretion of aqueous humor
by the ciliar body is normal. Injury of
what structure of the eyeball caused the
disorder of flow-out from the anterior
chamber?
A. Venous sinus
B. Ciliar body
C. Choroid
D. Ciliary muscle
E. Back epithelium of cornea
181. Chronic glomerulonephritis was di-
agnosed in a 34-year-old patient 3 years
ago. Edema has developed within the last
6 monthes. What caused the edema?
A. Proteinuria
B. Hyperproduction of vasopressin
C. Liver disfunction of protein formation
D. Hyperosmolarity of plasma
E. Hyperaldosteronism
182. Patient with diabetes mellitus experi-
enced loss of consciousness and convulsi-
ons after an injection of insulin. What
might be the result of biochemical blood
analysis for concentration of sugar?
20
A. 1,5 mmol/L
B. 8,0 mmol/L
C. 10,0 mmol/L
D. 3,3 mmol/L
E. 5,5 mmol/L
183. A 63-year-old woman developed
symptoms of rheumatoid arthritis. Their
increase of which blood values indicators
could be the most significant in proving
the diagnosis?
A. Additive glycosaminoglycans
B. Lipoproteids
C. Acid phosphatase
D. General cholesterol
E. R-glycosidase
184. An autopsy revealed large (1-2 cm)
brownish-red, easy crumbling formations
covering ulcerative defects on the external
surface of the aortic valve. What is the
most likely diagnosis?
A. Polypus-ulcerative endocarditis
B. Recurrent warty endocarditis
C. Acute warty endocarditis
D. Fibroplastic endocarditis
E. Diffusive endocarditis
185. Red colonies spread in the large
quantity in the Endo culture medium were
revealed on bacteriological stool exami-
nation of a 4-month-old baby with the
symptoms of acute bowel infection. What
microorganism can it be?
A. Escherichia
B. Salmonella
C. Staphylococcus
D. Streptococcus
E. Shigell
186. A patient with abscess of the cut
wound applied to the traumatological
department.The wound was washed with
3% hydrogen peroxide to be cleaned from
the pus. Foam was not observed. What
caused inefficiency of the drug?
A. Inherited insufficiency of catalase
B. Low concentration H2 O2
C. Inherited insufficiency erythrocyte’s
phosphatdehydrogenase
D. Shallow wound
E. Pus in the wound
187. A patient with injured muscles of
the lower extremities was admitted to
the traumatological department. Due to
what cells is reparative regeneration of
the muscle fibers and restoration of the
 Krok 1 Medicine 2005
muscle function possible?
A. Satellite-cells
B. Myoblasts
C. Myofibroblasts
D. Fibroblasts
E. Myoepithelial cells
188. The study of the genealogy of a fami-
ly with hypertrichosis (helix excessive pi-
losis) has demonstrated that this symptom
is manifested in all generations only in
men and is inherited by son from his
father. What is the type of hypertrichosis
inheritance?
A. Y-linked chromosome
B. Autosome-recessive
C. Autosome-dominant
D. X-linked recessive chromosome
E. X-linked dominant chromosome
189. A 50-year-old patient with typhoid
fever was treated with Levomycetin, the
next day his condition became worse,
temperature rose to 39, 60 . What caused
the complication?
A. The effect of endotoxin agent
B. Allergic reaction
C. Irresponsiveness of an agent to the
levomycetin
D. Secondary infection addition
E. Reinfection
190. A patient after pathological process
has a thickened alveolar membrane. The
direct consequence of the process will be
the reduction of:
A. Diffuse lung capacity
B. Oxygen capacity of blood
C. Minute respiratory capacity
D. Alveolar lung ventilation
E. Reserve expiratiory capacity
191. Where should the cathetor for
evacuation of the lymph from the thoracic
lymph duct be inserted?
A. To the left venous corner
B. To the right venous corner
C. To the superior vena cava
D. To the inferior vena cava
E. To the left inguinal vein
192. The penetration of the irritable cell
membrane for potassium ions has been
increased during an experiment. What
changes of membrane electric status can
occur?
21
A. Hyperpolarization
B. Depolarization
C. Action potential
D. Local response
E. No changes
193. The electronic microphoto of kidney
fragment has exposed afferent glomerular
arteriole, which has giant cells under
its endothelium, containing secretory
granules. Name the type of these cells:
A. Juxtaglomerular
B. Mesangial
C. Smoothmuscular
D. Juxtavascular
E. Interstitial
194. The energy inputs of a healthy man
have been measured. In what position was
the patient if his energy inputs were less
than the main exchange?
A. Sleep
B. Rest
C. Easy work
D. Nervous exertion
E. Calmness
195. A man after 1,5 litre blood loss has
suddenly reduced diuresis. The increased
secretion of what hormone caused such
diuresis alteration?
A. Vasopressin
B. Corticotropin
C. Natriuretic
D. Cortisol
E. Parathormone
196. A 2-year-old child has got intesti-
nal dysbacteriosis, which results in
hemorrhagic syndrome. What is the most
likely cause of hemorrhage of the child?
A. Vitamin K insufficiency
B. Activation of tissue thromboplastin
C. PP hypovitaminosis
D. Fibrinogen deficiency
E. Hypocalcemia
197. To anaesthetize the manipulation
related to burn surface treatment, a pati-
ent was intravenously injected a medi-
cation for short-acting narcosis. 1 minute
later the patient being under anaesthesia
had increased blood pressure, tachycardia,
increased tone of sceletal muscles; reflexes
remained. After awakening the patient
had desorientation and visual hallucinati-
ons. What medication was the patient
injected?
 Krok 1 Medicine 2005 22

A. Ketamine ltration. What is the most likely diagnosis?

B. Sombrevin
C. Diethyl ether A. Myocardial infarction
D. Thiopental sodium B. Myocardial ischemic dystrophy
E. Nitrous oxide C. Focal exudate myocarditis
D. Diffuse exudate myocarditis
198. During complicated labour the E. Productive myocarditis
symphysis pubis ruptured. What organ
can be damaged mostly? 200. A young man has an unpainfull
formation without marked borders in the
A. Urinary blader soft tissues of his thigh. On the tissue bi-
B. Rectum optate the formation lookes like flesh of
C. Ovaria fish and consists of immature fibroblast-
D. Uterine tubes like cells with multiple mitosis growing
E. Uterus through the muscles. What is the most li-
kely diagnosis?
199. A patient died from acute cardiac
insufficiency. The histological examinati- A. Fibrosarcoma
on of his heart revealed the necrotized B. Myosarcoma
section in myocardium of the left ventri- C. Fibroma
cle, which was separated from undamaged D. Cancer
tissue by the zone of hyperimic vessels, E. Myoma
small hemorrhages and leukocytic infi-
 Krok 1 Medicine 2006 1

1. A patient with hypochromic anemia A. Galactose-1-phosphate uri-

has splitting hair and loss of hair, increased
nail brittling and taste alteration. What
is the mechanism of the development of
these symptoms?
A. Deficiency of iron-containing enzymes
B. Deficiency of vitamin 12
C. Decreased production of parathyrin
D. Deficiency of vitamin А
E. Decreased production of thyroid
hormones
2. A 27-year-old woman has dropped
penicillin containing eye drops. In a few
minutes there appeared feeling of itchi-
ng, burning of the skin, lips and eyeli-
ds edema, whistling cough, decrease of
BP. What imunoglobulins take part in the
development of this allergic reaction?
A. IgE and IgG
B. IgM and IgG
C. IgA and IgM
D. IgM and IgD
E. IgG and IgD
3. A person felt thirsty after staying under
the conditions of hot weather for a long
time. Signals of what receptors caused it
first of all?
A. Osmoreceptors of hypothalamus
B. Sodium receptors of hypothalamus
C. Osmoreceptors of liver
D. Glucoreceptors of hypothalamus
E. Baroreceptors of aortic arch
4. Slime, blood and protozoa 30-200 mi-
crons long have been revealed in a man’s
feces. The body is covered with cilias
and has correct oval form with a little
bit narrowed anterior and wide round
shaped posterior end. At the anterior end
a mouth is visible. In cytoplasm there are
two nucleui and two short vacuoles. What
are the described features typical for?
A. Balantidium
B. Lamblia
C. Dysenteric amoeba
D. Trichomonas
E. Intestinal amoeba
5. A child has got galactosemia.
Concentration of glucose in blood has not
considerably changed. Deficiency of what
enzyme caused this illness?
dyltransferase
B. Amylo-1,6-glucosidase
C. Phosphoglucomutase
D. Galactokinase
E. Hexokinase
6. Synthesis of phospholipids is disturbed
as a result fatty infiltration of liver. Indi-
cate which of the following substances can
enhance the process of methylation duri-
ng phospholipids synthesis?
A. Methionine
B. Ascorbic acid
C. Glucose
D. Glycerin
E. Citrate
7. An individual is characterized by
rounded face, broad forehead, a mongoli-
an type of eyelid fold, flattened nasal bri-
dge, permanently open mouth, projecting
lower lip, protruding tongue, short neck,
flat hands, and stubby fingers. What di-
agnosis can be put to the patient?
A. Down’s syndrome
B. Klinefelter’s syndrome
C. Alkaptonuria
D. Supermales
E. Turner’s syndrome
8. A patient visited a dentist with complai-
nts of redness and edema of his mouth
mucous membrane in a month after dental
prosthesis. The patient was diagnosed wi-
th allergic stomatitis. What type of allergic
reaction by Gell and Cumbs underlies this
disease?
A. Delayed type hypersensitivity
B. Cytotoxic
C. Immunocomplex
D. Anaphylactic
E. Stimulating
9. A patient suffering from trombophlebi-
tis of the deep crural veins suddenly
died. Autopsy has shown freely lying
red friable masses with dim crimped
surface in the trunk and bifurcation of
the pulmonary artery. What pathologic
process was revealed by morbid anatomi-
st?
A. Tromboembolism
B. Thrombosis
C. Tissue embolism
D. Embolism with foreign body
E. Fat embolism
10. Decreased blood supply to the organs
 Krok 1 Medicine 2006
causes hypoxia that activates fibroblasts
function. Volume of what elements is
increased in this case?
A. Intercellular substance
B. Vessels of microcircular stream
C. Nerve elements
D. Parenchymatous elements of an organ
E. Lymphatic vessels
11. RNA-polymerase B(II) is blocked due
to amanitine poisoning (poison of death-
cup). It disturbs:
A. Synthesis of m-RNA
B. Synthesis of t-RNA
C. Reverse transcription
D. Primers synthesis
E. Maturation of m-RNA
12. Secretion of what gastrointestinal
hormones will be primarily decreased as a
result of iduodenum removal?
A. Cholecystokinin and secretin
B. Gastrin
C. Histamine
D. Gastrin and histamine
E. Neurotensin
13. It is planned to use the territory of
an old cattle burial ground (which is
not used for more than 50 years) for
building houses. But ground analysis
revealed presence of the pathogen of a
very dangerous illness. Which of the indi-
cated microorgonisms is likely to remain
in the ground for such a long time?
A. Bacillus anthracis
B. Francisella tularensis
C. Brucella abortus
D. Yersinia pestis
E. Mycobacterium bovis
14. From the nasopharynx of a 5-
year-old child it was excreted a mi-
croorganism which is identical to
Corynebacterium diphtheriae dose
according to morphological and bi-
ochemical signs. But this microorganism
does not produce exotoxin. As a result
of what process can this microorganism
become toxigenic?
A. Phage conversion
B. Cultivation in the telluric environment
C. Passing through the organism of the
sensative animals
D. Growing with antitoxic serum
E. Chromosome mutation
15. A patient with encephalopathy
2
was admitted to the neurological in-
patient department. There was revealed
a correlation between increasing of
encephalopathy and substances absorbed
by the bloodstream from the intestines.
What substances that are formed in the
intestines can cause endotoxemia?
A. Indole
B. Butyrate
C. Acetacetate
D. Biotin
E. Ornithine
16. A 50-year-old man has felt vague
abdominal discomfort within past 4
months. Physical examination revealed
no lymphadenopathy, and no abdomi-
nal masses or organomegaly at palpation.
Bowel sounds are heard. An abdominal
CT scan shows a 20 cm retroperitoneal
soft tissue mass obscuring the left psoas
muscle. A stool specimen tested for occult
blood is negative. Which of the following
neoplasms is this man most likely to have?
A. Lipoma
B. Melanoma
C. Hamartoma
D. Adenocarcinoma
E. Lymphoma
17. A patient has undergone an amputati-
on of lower extremity. Some time later
painful nodules appeared in a stump.
Amputatious neuromas were found out
at the microscopic examination. To what
pathological processes do those formati-
ons relate?
A. Regeneration
B. Dystrophy
C. Inflammation
D. Hyperemia
E. Metaplasia
18. During the fetal period of the
development in the vascular system of
the fetus a large arterial (Botallo’s)
duct is functioning which converts into
lig.arteriosum after birth. What anatomi-
cal formations does this duct connect?
A. Pulmonary trunk and aorta
B. Right and left auricles
C. Aorta and inferior vena cava
D. Pulmonary trunk and superior vena
cava
E. Aorta and superior vena cava
19. A 22-year-old patient was admitted
to the hospital with complaints of heavy
nasal breathing. During the examination
 Krok 1 Medicine 2006 3

of her nasal cavity the doctors found thi- A. .latissimus dorsi

ckened mucous membrane, a lot of mucus B. .levator scapulae
and nodular infiltrates without erosions C. .romboideus major
in the nose.The nasal rhinoscleroma was D. .trapezius
diagnosed. The biopsy was taken. What E. .subscapularis
typical morphological changes may be
found? 24. A 52-year-old patient has the followi-
ng diagnosis: systemic amebiasis with
A. Granulomas with Mikulicz’s cells involvment of intestines, liver, lungs. What
B. Granulomas with Virchow’s cells drug should be prescribed?
C. Granulomas with Langhan’s cells
D. Granulomas with foreign body cells A. Metronidasol
E. Interstitial inflammation B. Quiniofone
C. Tetracycline
20. Intake of oral contraceptives containi- D. Quingamine
ng sex hormones inhibits secretion of the E. Enteroseptol
hypophysiae hormones. Secretion of whi-
ch of the indicated hormones is inhibited 25. A 38-year-old man who poisoned hi-
while taking oral contraceptives with sex mself with mercury dichloride was taken
hormones? to the admission room in grave conditi-
on. What antidote should be immediately
A. Follicle-stimulating introduced?
B. Vasopressin
C. Thyrotropic A. Unithiol
D. Somatotropic B. Dipiroxim
E. Oxytocin C. Atropine
D. Nalorphine
21. A 60-year-old patient was admi- E. Isonitrosine
tted to the surgical department because
of infection caused by blue pus baci- 26. Children often have heavy nasal
llus (Pseudomonas aeruginosa) which is breathing resulting from excessive
sensative to penicillin antibiotics. Indicate development of lymphoid tissue of
which of the given penicillins has marked pharyngeal mucous membrane. What
activity to the Pseudomonas aeruginosa? tonsils growth may cause this effect?

A. Carbenicillin disodium A. T onsilla pharyngea

B. Benzylpenicillin B. T onsilla palatina
C. Phenoxymethylpenicillin C. T onsilla lingualis
D. Oxacillin D. T onsilla tubaria
E. Methicillin E. All above mentioned tonsils

22. A 45-year-old woman suffers from
seasonal allergic rhinitis caused by the
ambrosia blossoming. What medicine
from the stabilizer of the adipose cells
group can be used for prevention of this
disease?
27. The alternate usage of dichlotiazide,
etacrin acid and lasex did not influence
diuretically upon the patient with marked
peripheral edemata. The aldosterone rate
in the blood is increased. Indicate which
medicine should be prescribed:

A. Ketotifen A. Spironolacton
B. Diazoline B. Mannit
C. Phencarol C. Clopamid
D. Tavegyl D. Urea
E. Dimedrol E. Amilorid

23. A young man felt acute pain in the
back during active drawing up on the hori-
zontal bar. Objectively: pain while movi-
ng upper extremity, reduced pronation
and adduction functions. Sprain of what
muscle can be observed here?
28. A 46-year-old man complains of di-
fficulties with nasal breathing. Mikulicz’s
cells, accumulation of epithelioid cells,
plasmocytes, lymphocytes, hyaline balls
were discovered in the biopsy material of
the thickened nasal mucosa. What is the
most likely diagnosis?
 Krok 1 Medicine 2006
A. Scleroma
B. Virus rhinitis
C. Allergic rhinitis
D. Rhinovirus infection
E. Meningococcal nasopharyngitis
29. A 56-year-old patient complaining
of thirst and frequent urination was di-
agnosed with diabete mellitus. Butamin
was prescribed. How does the medicine
act?
A. It stimulates β-cells of Langergans’
islets
B. It helps to absorb the glucose by the
cells of the organism tissues
C. It relieves transport of glucose through
the cells’ membranes
D. It inhibits α-cells of Langergans’ islets
E. It inhibits absorption of glucose in the
intestines
30. A man who was bitten by the unknown
dog applied to the surgeon. Wide ragged
woundes were localized on the face. What
curative-prophylactic aid should be given
to prevent rabies?
A. Start immunisation with rabies vaccine
B. Prescribe combined antibiotic therapy
C. Immediate injection of
DPT(Diphtheria, Pertusis, Tetanus)
vaccine
D. Hospitalize the patient and keep under
the doctor’s supervision
E. Immediately inject normal gamma
globulin
31. A patient with clinical signs of
immunodeficiency has no changes of
the number and functional activity of
T- and B- lymphocytes. Defect with di-
sfunction of antigen-presentation to the
immunocompetent cells was found during
examinatio on the molecule level. Defect
of what cells is the most probable?
A. Macrophages, monocytes
B. Т-lymphocytes, В-lymphocytes
C. NK-cells
D. Fibroblasts, Т-lymphocytes, В-
lymphocytes
E. 0-lymphocytes
32. A 38-year-old woman was admitted to
the admission-diagnostic department with
uterine bleeding. What are the most likely
changes of blood?
4
A. Reduction of haematocrite rate
B. Increase of haematocrite rate
C. Leukopenia
D. Leucocytosis
E. Polycythemia
33. A 60-year-old patient has reduced
perception of high-frequency sounds.
What structures’ disorder of auditory
analizer caused these changes?
A. Main membrane of cochlea near the
oval window
B. Main membrane of cochlea near heli-
cotrema
C. Eustachian tube
D. Muscles of middle ear
E. Tympanic membrane
34. The effect of electric current on the
exitable cell caused depolarization of
its membrane. Movement of what ions
through the membrane caused depolari-
sation?
A. Na+
B. −
3
C. 2+
D. l−
E. +
35. Live vaccine was injected into the
human body. Increasing activity of what
connective tissue cells can be expected?
A. Plasmocytes and lymphocytes
B. Macrophages and fibroblasts
C. Pigmentocytes and pericytes
D. Adipocytes and adventitious cells
E. Fibroblasts and labrocytes
36. When a patient with traumatic impai-
rment of the brain was examined, it was
discovered that he had stopped to di-
stinguish displacement of an object on
the skin. What part of the brain was
damaged?
A. Posterior central gurus
B. Occipital zone of the cortex
C. Parietal zone of the cortex
D. Frontal central gurus
E. Frontal zone
37. In the blood of a 26-year-old man
18% of erythrocytes of the spherical, ball-
shaped, flat and spinous shape have been
revealed. Other eritrocytes were in form
of the concavo-concave disks. How is this
phenomenon called?
 Krok 1 Medicine 2006
A. Physiological poikilocytosis
B. Pathological poikilocytosis
C. Physiological anisocytosis
D. Pathological anisocytosis
E. Erytrocytosis
38. A 10-year-old girl often experiences
acute respiratory infections with multi-
ple punctate haemorrages in the places of
clothes friction. Hypovitaminosis of what
vitamin has the girl?
A.
B. 6 D. Branches of His’ bundle
C. 1 E. Purkinje’s fibers
D.
E. 2
39. Different functional groups can be
presented in the structure of L-amino aci-
d’s radicals. Identify the group that is able
to form ester bond:
A. −OH
B. −SH
C. −CONH2
D. −CH3
E. −NH2
40. Moving of the daughter chromatids to
the poles of the cell is observed in the mi-
totically dividing cell. At what stage of the
mitotic cycle is this cell?
A. Anaphase
B. Metaphase
C. Telophase
D. Prophase
E. Interphase
41. During examination of a patient,
there was found a neoplasm in the whi-
te substance of cerebral hemispheres with
localization in the knee and frontal part
of posterior crus of internal capsule. Fi-
bres of what conductive tract of the brain
will be disrupted?
A. T r. pyramidalis
B. T r. f rontothalamicus
C. r. thalamocorticalis
D. T r. f rontopontinus
E. T r. parietooccipitopontinus
42. A patient with diabetes mellitus has
been delivered in hospital in the state of
unconsciousness. Arterial pressure is low.
The patient has acidosis. Point substances,
which accumulation in the blood results in
these manifestations:
5
A. Ketone bodies
B. Amino acids
C. Monosaccharides
D. High fatty acids
E. Cholesterol esters
43. A person has steady HR not exceedi-
ng 40 bpm. What is the pacemaker of this
person’s heart rhythm?
A. Atrioventricular node
B. Sinoatrial node
C. His’ bundle
44. A doctor administered Allopurinol
to a 26-year-old young man with the
symptoms of gout. What pharmacological
action of Allopurinol ensures therapeuti-
cal effect?
A. By inhibiting uric acid synthesis
B. By increasing uric acid excretion
C. By inhibiting leucocyte migration into
the joint
D. By general anti-inflammatory effect
E. By general analgetic effect
45. A patient who came to the doctor
because of his infertility was admini-
stered to make tests for toxoplasmosis
and chronic gonorrhoea. Which reacti-
on should be performed to reveal latent
toxoplasmosis and chronic gonorrhoea of
the patient?
A. (R)CFT- Reiter’s complement fixation
test
B. IFA - Immunofluorescence assay
C. Immunoblot analysis
D. RDHA - Reverse direct hemaggluti-
nation assay
E. RIHA - Reverse indirect hemaggluti-
nation assay
46. Under some diseases it is
observed aldosteronism accompanied by
hypertension and edema due to sodium
retention in the organism. What organ of
the internal secretion is affected under
aldosteronism?
A. Adrenal glands
B. Testicle
C. Ovaries
D. Pancreas
E. Hypophysis
47. A patient had been taking glucocorti-
coids for a long time. When the
preparation was withdrawn he developed
the symptoms of disease aggravation,
 Krok 1 Medicine 2006
decreased blood pressure and weakness.
What is the reason of this condition?
A. Appearance of adrenal insufficiency
B. Hyperproduction of ACTH
C. Sensibilization
D. Habituation
E. Cumulation
48. A patient has tissue ischemia below
the knee joint accompanied with intermi-
ttent claudication. What artery occlusion
should be suspected?
A. Popliteal artery
B. Peroneal artery
C. Posterior tibial artery
D. Anterior tibial artery
E. Proximal part of femoral artery
49. An experiment proved that UV-
radiated cells of patients with xeroderma
pigmentosum restore the native DNA
structure slower than cells of healthy
individuals as a result of reparation
enzyme defection. What enzyme helps
this process?
A. Endonuclease
B. RNA ligase
C. Primase
D. DNA polymerase III
E. DNA gyirase
50. A patient, who suffers from congeni-
tal erythropoietic porphyria, has skin
photosensitivity. The accumulation of
what compound in the skin cells can cause
it?
A. Uroporphyrinogen 1
B. Protoporphyrin
C. Uroporphyrinogen 2
D. Coproporphyrinogen 3
E. Heme
51. A sick man with high temperature and
a lot of tiny wounds on the body has been
admitted to the hospital. Lice have been
found in the folds of his clothing. What
disease can be suspected?
A. Epidemic typhus
B. Tularemia
C. Scabies
D. Malaria
E. Plague
52. A patient with suspicion on epidemic
typhus was admitted to the hospital. Some
arachnids and insects have been found in
his flat. Which of them may be a carrier of
the pathogen of epidemic typhus?
6
A. Lice
B. Spiders
C. Bed-bugs
D. Cockroaches
E. Houseflies
53. A businessman came to India from
South America. On examination the
physician found that the patient was
suffering from sleeping-sickness. What
was the way of invasion?
A. As a result of bug’s bites
B. As a result of mosquito’s bites
C. With contaminated fruits and vegetables
D. Through dirty hands
E. After contact with sick dogs
54. Patients with bile ducts obstruction
suffer from inhibition of blood coagulati-
on, bleedings as a result of low level of
vitamin assimilation. What vitamin is in
deficiency?
A. К
B. А
C. D
D. Е
E. Carotene
55. Blood analysis of a patient showed si-
gns of HIV infection (human immunodefi-
ciency virus). Which cells does HIV-virus
primarily affect?
A. Cells that contain receptor T4 (T-
helpers)
B. Cells that contain receptor IgM (B-
lymphocytes)
C. Specialized nervous cells (neurons)
D. Mast cells
E. Proliferating cells (stem hematoplastic
cells)
56. The preventive radioprotector was
given to a worker of a nuclear power
station. What mechanism from the below
mentioned is considered to be the main
mechanism of radioprotection?
A. Inhibition of free radicals formation
B. Prevention of tissue’s hypoxia
C. Activation of oxidation reactions
D. Increasing of tissue blood supply
E. Increasing of respiration
57. The pulmonalis embolism has
suddenly developed in a 40-year-old pati-
ent with opened fracture of the hip.
Choose the possible kind of embolism:
 Krok 1 Medicine 2006 7

A. Fat out-patient department with the complai-

B. Thrombus-embolus nts of bleeding trauma in the vestibule of
C. Air his nose. On examination: the mechanical
D. Tissue injury of the mucous layer of the vesti-
E. Foreign body bule without continuation into nasal cavi-
ty proper. What is the boundary between
58. A patient’s blood was analyzed and the vestibule and nasal cavity proper?
the decreased erythrocyte’s sedimentation
rate (ESR) was discovered. What disease A. Nasal limen
from the listed below is accompanied with B. Nasal roller
decreased ESR? C. Nasal septa
D. Choanes
A. Polycytemia E. Nostrils
B. Hepatitis
C. Splenomegaly 63. A 50-year-old patient was injured
D. Vitamin B deficiency on the occipital region of the head. The
E. Myocardial infarction closed skull trauma was diagnosed. She
was taken to the hospital. The medical
59. A 46-year-old patient has complai- examination: deregulation of walking and
ned of headache, fatigue, thirst, pains balance, trembling of arms. What part of
in the spine and joints for the last 2 brain was injured?
years. Clinically observed disproportional
enlargement of hands, feet, nose, superci- A. The cerebellum
liary arches. He notes that he needed B. The medulla oblongata
to buy bigger shoes three times. What C. The mind-brain
is the main reason of such disproporti- D. The inter-brain
onal enlargement of different parts of the E. The spinal cord
body?
64. A patient with complaints of dryness
A. Cartilaginous tissue proliferation under in the mouth, photophobia and visi-
growth hormone influence on impairment was admitted to the
B. Increased sensitivity of the tissues to reception-room. Skin is hyperemic, dry,
growth hormone pupils are dilated, tachycardia. Poisoning
C. Joints dystrophy development with belladonna alkaloids was diagnosed
D. Increased sensitivity of the tissues to on further examination. What medicine
insulin should be prescribed?
E. Joints chronic inflammation
development A. Prozerin
B. Diazepam
60. A mother of a newborn complai- C. Pilocarpine
ns of her baby’s constant belching with D. Armine
undigested milk. Which developmental E. Dipiroxim
anomaly is it an evidence of?
65. Autopsy revealed that right lung is
A. Esophageal atresia enlarged, solid, there are fibrin layers on
B. Labium leporium the pleura. Lung tissue is light grey color
C. Faux lupinum on incision with muddy liqued exudates.
D. Anal atresia What lung disease are these symptoms
E. Esophageal fistula typical for?
61. During the endoscopy the inflammati- A. Croupous pneumonia
on of a major papilla of the duodenum B. Bronchopneumonia
and the disturbances of bile secretion C. Interstitial pneumonia
were found. In which part of duodenum D. Pulmonary gangrene
were the problems found? E. Fibrosing alveolitis
A. Descendent part 66. During the operation on the hip joi-
B. Ascendant part nt of a 5-year-old child her ligament was
C. Bulb damaged which caused bleeding.What li-
D. Upper horizontal part gament was damaged?
E. Lower horizontal part
62. An 18-year-old patient came to the
 Krok 1 Medicine 2006
A. The head of the thigh
B. Perpendicular of the acetabule
C. Iliofemoral
D. Pubofemoral
E. Ischiofemoral
67. On autopsy it was revealed: pia mater
of the upper parts of cerebral hemisphere
is plethoric, of yellowish-green color,
soaked with purulent and fibrose exudate,
looks like a cap. What disease is it typical
for?
A. Meningococcal meningitis
B. Tuberculous meningitis
C. Grippal meningitis
D. Meningitis connected with anthrax
E. Meningitis connected with typhus
68. A 55-year-old patient with continuing
ventricular arrhythmias was admitted to
the hospital. The patient is taking timolol
drops for glaucoma, daily insulin injecti-
ons for diabetes mellitus, and an ACE
inhibitor for hypertension. You have deci-
ded to use phenytoin instead of procai-
namide. What is the reason?
A. The anticholinergic effect of procai-
namide would aggravate glaucoma
B. The local anesthetic effect of procai-
namide would potentiate diabetes
C. The hypertensive effects of procainami-
de would aggravate the hypertension
D. The local anesthetic effect of procai-
namide would aggravate the hypertension
E. The cholinergic effects of procainamide
would aggravate the diabetes
69. A 35-year-old man under the
treatment for pulmonary tuberculosis has
acute pain onset of right big toe, swelling,
and low-grade fever. The gouty arthritis
was diagnosed and high serum uric acid
level was found. Which of the followi-
ng antituberculous drugs are known for
causing high uric acid levels?
A. Pyrazinamide
B. Cycloserine
C. Thiacetazone
D. Rifampicin
E. Aminosalicylic acid
70. A person was selling "homemade
pork"sausages at the market. State sani-
tary inspector suspected falcification of
the sausages. What serological immune
reaction can identifiy food substance?
8
A. Precipitation test
B. Indirect hemagglutination test
C. Agglutination test
D. Immunofluorescence test
E. Complement-fixation test
71. A patient with rheumatoid arthritis
who had been treated with indometacin
has got signs of gastropathy. What acti-
vity of the drug can this complication be
connected with?
A. Anticyclooxygenase
B. Antiserotonin
C. Antihistamine
D. Antikinine
E. Locally irritating
72. A 25-year-old woman with red and
itchy eczematoid dermatitis visits your
office. She had a dental procedure one
day earlier with administration of a local
anesthetic. There were no other findings,
although she indicated that she had a hi-
story of allergic reactions. Which of the
following drugs is most likely involved?
A. Procaine
B. Cocaine
C. Lidocaine
D. Bupivacaine
E. Etidocaine
73. In course of metabolic process active
forms of oxygen including superoxide ani-
on radical are formed in the human body.
By means of what enzyme is this anion
inactivated?
A. Superoxide dismutase
B. Catalase
C. Peroxidase
D. Glutathioneperoxidase
E. Glutathionereductase
74. A patient has elbow joint trauma
with avulsion of medial epicondyle of
humerus. What nerve can be damaged in
this trauma?
A. Ulnar
B. Radial
C. Musculocutaneous nerve
D. Cardiac cutaneous nerve
E. Medial cutaneous nerve of forearm
75. A student is writing a thorough
summary of a lecture. Quality of summari-
zing has considerably worsened when his
neighbours started talking. What kind of
inhibition in the cerebral cortex caused
this effect?
 Krok 1 Medicine 2006
A. External
B. Protective
C. Fading
D. Differentiated
E. Delayed
76. While enrolling a child to school
Mantu’s test was made to define whether
revaccination was needed. The test result
is negative. What does this test result
mean?
A. Absence of cell immunity to the
tuberculosis
B. Presence of cell immunity to the
tuberculosis
C. Absence of antibodies for tubercle
bacillus
D. Absence of antitoxic immunity to the
tuberculosis
E. Presence of antibodies for tubercle
bacillus
77. The donor who didn’t donate the blood
for a long time was investigated with
IFA method. Anti-HBs antibodies were
revealed. What does positive result of IFA
in this case mean?
A. Previous hepatitis B
B. Acute hepatitis B
C. Acute hepatitis C
D. Chronic hepatitis В
E. Chronic hepatitis С
78. 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 substrate is this action caused?
A. Nuclear receptors
B. Membrane receptors
C. Ribosomes
D. Chromatin
E. Proteins-activators of transcription
79. Inhibition of α-motoneuron of the
extensor muscles was noticed after sti-
mulation of α-motoneuron of the flexor
muscles during the experiment on the spi-
nal cord. What type of inhibition is this
process based upon?
A. Reciprocal
B. Presynaptic
C. Depolarizational
D. Recurrent
E. Lateral
80. A patient who has been strictly keepi-
ng to a certain diet for 10 days went
through examination of respiratory coeffi-
9
cient. It was determined that it was equal
1. What have the patient been keeping to?
A. With domination of carbohydrates
B. With domination of proteins and fat
C. With domination of fat and
carbohydrates
D. Mixed
E. With domination of proteins and
carbohydrates
81. Buffer capacity of a worker’s blood
was decreased due to exhausting muscular
work. By coming of what acid substance
in the blood can this state be explained?
A. Lactate
B. Pyruvate
C. 1,3-bisphosphoglycerate
D. α-ketoglutarate
E. 3-phosphoglycerate
82. Examination of initial molecular
structure revealed substitution of the
glutamic acid by valine. What inherited
pathology is it typical for?
A. Sickle-cell anemia
B. Thalassemia
C. Minkowsky-Shauffard disease
D. Favism
E. Hemoglobinosis
83. Inflamation is characterised by
increased permeability of vessels of mi-
crocirculation stream, increase of their
hydrodynamic blood pressure. Increasing
of the osmotic concentration and dispersi-
ty of protein structures is present in the
intercellular fluid. What kind of edema
will appear in this case?
A. Mixed
B. Hydrodynamic
C. Colloid-osmotic
D. Lymphogenic
E. Membranogenic
84. Increased fragility of vessels, enamel
and dentine destruction resulting from
scurvy are caused by disorder of collagen
maturation. What stage of procollagen
modification is disturbed under this avi-
taminosis?
A. Hydroxylation of proline
B. Formation of polypeptide chains
C. Glycosylation of hydroxylysine residues
D. Removal of C-ended peptide from
procollagen
E. Detaching of N-ended peptide
85. Scraps of the mycelium of a fungus,
 Krok 1 Medicine 2006 10

spores, air bubbles and fat drops were di- 90. A person has reduced di-
scovered on microscopy of the patient’s uresis, hypernatremia, hypokalemia.
hair excluded from the infected areas. Hypersecretion of what hormone can
What fungus disease is characterised by cause such changes?
this microscopic picture?
A. Aldosterone
A. Favus B. Vasopressin
B. Microspory C. Auricular sodiumuretic factor
C. Trichophytosis D. Adrenalin
D. Epidermophytosis E. Parathormone
E. Sporotrichosis
91. Microspecimen of red bone marrow
86. On autopsy of the 58-year-old man it contains multiple capillares through
was revealed: mitral valve is deformed, the walls of which mature blood cells
thickened, not totally closed. Microscopi- penetrate into the bloodstream. What
cally: foci of collagen fibers are eosinophi- type of capillares are these?
lic, have positive fibrin reaction. The most
likely it is: A. Sinusoidal
B. Fenestrational
A. Fibrinoid swelling C. Somatical
B. Fibrinoid inflammation D. Visceral
C. Mucoid swelling E. Lymphatic
D. Hyalinosis
E. Amyloidosis 92. A 57-year-old patient was admitted
to the gastroenterological department wi-
87. Hypertrychosis of auricles is caused by th suspicion of Zollinger-Ellison syndrom
a gene that is localized in Y-chromosome. because of rapid increase of gastrin level
Father has this feature. What is the in the blood serum. What is the most
probability to give birth to a boy with such probable disorder of the secretory functi-
anomaly? on of stomach?
A. 100% A. Hyperacidic hypersecretion
B. 0% B. Hyperacidic hyposecretion
C. 25% C. Achylia
D. 35% D. Hypoacidic hyposecretion
E. 75% E. Hypoacidic hypersecretion
88. A 54-year-old man was admitted to the 93. For a long time a 49-year-old woman
hospital with complaints of pain in the ri- had suffered from glomerulonephritis
ght subcostal region, vomiting with blood. which caused death. The autopsy revealed
Objectively: enlarged liver, varicose veins that the size of her kidneys was 7 х
in the stomach and esophagus. Disfuncti- 3 х 2,5 cm, weight 65,0 g, they were
on of what vessel is likely to have taken dense and small-grained. Microscopically:
place? fibrinogenous inflammation of serous
and mucous membranes, dystrophic
A. V ena porta changes of parenchymatous organs, brain
B. Aorta abdominalis edema. What complication can cause such
C. V ena hepatica changes of serous membranes and inner
D. V ena cava superior organs?
E. V ena cava inf erior
A. Uraemia
89. A 37-year-old man was admitted B. Anemia
to the surgical department with the C. Sepsis
symptoms of acute pancreatitis: vomiti- D. DIC-syndrome
ng, diarrhea, bradycardia, hypotention, E. Thrombopenia
weakness, dehydration of the organism.
What medicine should be used first of all? 94. Upper neck node of sympathetic
trunk was removed from the rabbit on
A. Contrycal experiment. Reddening and increased
B. No-spa temperature of the skin of head is
C. Platyphylline observed. What disorder of peripheral ci-
D. Etaperazine rculation of the blood has developed?
E. Ephedrine
 Krok 1 Medicine 2006
A. Neuroparalytic arterial hyperemia
B. Neurotonic arterial hyperemia
C. Metabolic arterial hyperemia
D. Venous hyperemia
E. Stasis
95. A tissue sample of benign tumor was
studied under the electron microscope.
A lot of small (15-20 nm) spherical bodi-
es, consisting of 2 unequal subunits were
detected. These are:
A. Ribosomes
B. Golgi complex
C. Smooth endoplasmic reticulum
D. Microtubules
E. Mitochondria
96. A woman who was infected with
toxoplasmosis during the pregnancy has
born a child with multiple congenital
defects.This is a result of:
A. Teratogenesis
B. Cancerogenesis
C. Biological mutogenesis
D. Chemical mutogenesis
E. Recombination
97. A considerable increase of activity of
МВ-forms of CPK (creatinephosphoki-
nase) and LDH-1 was revealed on the
examination of patient’s blood. What is
the most likely pathology?
A. Miocardial infarction
B. Hepatitis
C. Rheumatism
D. Pancreatitis
E. Cholecystitis
98. An isolated muscle of a frog
is rhythmically irritated with electric
impulses. Every next impulse is in a period
of relaxation from the previus contraction.
What contraction of the muscle occurs?
A. Waved tetanus
B. Single
C. Asynchronous
D. Continuous (smooth) tetanus
E. Tonic
99. A 16-year-old boy was performed an
appendectomy. He has been hospitalized
for right lower quadrant abdominal pain
within 18 hours. The surgical specimen is
edematous and erythematous. Infiltration
by what of the following cells is the most
typical for the process occuring here?
11
A. Neutrophils
B. Eosinophils
C. Basophils
D. Limphocytes
E. Monocytes
100. ATP synthesis is totaly blocked in a
cell. How will the value of membrane rest
potential change?
A. It will disappear
B. It will be slightly increased
C. It will be considerably increased
D. First it will increase, then decrease
E. First it will decrease, then increase
101. A patient who was previously ill with
mastectomy as a result of breast cancer
was prescribed radiation therapy. What
vitamin preparation has marked radi-
oprotective action caused by antioxidant
activity?
A. Tocopherol acetate
B. Ergocalciferol
C. Thiamine chloride
D. Riboflavin
E. Folic acid
102. A patient with tissue trauma was
taken a blood sample for the determinati-
on of blood clotting parameters. Specify
the right sequence of extrinsic pathway
activation:
A. III - VIIa - Xa
B. III - IV - Xa
C. IV - VIII: TF - Xa
D. IV - VIIa - Xa
E. III - VIII: TF - Xa
103. Autopsy of a man who died from
chronic cardiacvascular collapse revealed
"tiger heart". Sidewards of endocardium
a yellowish-white banding can be seen;
myocardium is dull, dark-yellow. What
process caused this pathology?
A. Fatty parenchymatous degeneration
B. Carbohydrate degeneration
C. Hyaline degeneration
D. Fatty vascular-stromal degeneration
E. Amyloidosis
104. Parents with an ill child consulted
an infectionist. They had been working in
one of Asian countries for a long time.
The child has sallow skin, loss of appeti-
te, laxity, enlarged liver, spleen, peripheral
lymph nodes. What protozoal illness can
be suspected?
 Krok 1 Medicine 2006
A. Visceral leishmaniasis
B. Balantidiasis
C. Amebiasis
D. Toxoplasmosis
E. Lambliasis
105. Healthy parents have got a fair-
haired, blue-eyed girl. Irritability, anxiety,
sleep and feeding disturbance developed
in the first months of the infant’s li-
fe. Neurological examination revealed
developmental lag. What method of
genetic investigation should be used for
the exact diagnosis?
A. Biochemical
B. Cytological
C. Gemellary
D. Genealogical
E. Population-statistical
106. The process of heart transplantati-
on determined the viability of myocardi-
al cells. The determination of what
myocardium parameter is the most
important?
A. Rest potential of cardiomyocytes
B. Heart temperature
C. Concentration of oxygen in heart vessels
D. Concentration of calcium-ions in myofi-
brils
E. Concentration of Ca-ions in heart
vessels
107. The calcium canals of cardiomyocytes
have been blocked on an isolated rabbit’s
heart. What changes in the heart’s activity
can result from it?
A. Decreased rate and force of heart beat
B. Decreased heart beat rate
C. Decreased force of the contraction
D. Heart stops in systole
E. Heart stops in diastole
108. Microscopic examination of the
enlarged neck gland of a 14-year-old
girl revealed destruction of the ti-
ssue structure of the node, absence of
the lymph follicles, sclerotic areas and
necrosis foci, cell constitution of the node
is polymorphous, lymphocites, eosinophi-
les, big atypical cells with multilobular
nuclei (Beresovsky-Sternberg cells) and
mononuclear cells of the large size are
present. What is the most likely diagnosis?
12
A. Lymphogranulomatosis
B. Acute lympholeucosis
C. Chronic lympholeucosis
D. Berkitt’s lymphoma
E. Fungoid mycosis
109. As a result of the damage of one of
the Atomic Power Plant reactors the run-
out of radioelements took place. People
in the high-radiation area were radiated
with approximately 250-300 r. They were
immediately hospitalized. What changes
in the blood count would be typical for
the victims?
A. Lymphopenia
B. Leukopenia
C. Anemia
D. Thrombopenia
E. Neutropenia
110. Dystrophic alterations of heart are
accompanied with dilation of heart caviti-
es, decreased force of heart contractions,
increased blood volume that remains duri-
ng systole in the heart cavity, vein overfill.
What heart condition is it typiccal for?
A. Myogenic dilatation
B. Tonogenic dilatation
C. Emergency stage of hyperfunction and
hypertrophy
D. Cardiosclerosis
E. Cardiac tamponade
111. Nowadays about 50 minor bases
have been found in the t-RNA structure
besides the main four nitrogenous bases.
Choose the minor nitrogenous base:
A. Dihydrouracil
B. Uracil
C. Cysteine
D. Adenine
E. Cytosine
112. A 60-year-old patient fell ill with
obturative jaundice as a result of mali-
gnant tumour of the big papillary of the
duodenal. Lumen of what anatomical
structure is compressed by tumour?
A. Hepatopancreatic ampulla
B. Cystic duct
C. Common hepatic duct
D. Right hepatic duct
E. Left hepatic duct
113. Thyrotoxicosis leads to increased
production of thyroidal hormones T3 and
T4 , weight loss, tachycardia, psychic exci-
tement and so on. How do thyroidal
hormones effect energy metabolism in the
 Krok 1 Medicine 2006
mitochondrion of cells?
A. Disconnect oxidation and oxidative
phosphorylation
B. Activate substrate phosphorylation
C. Stop substrate phosphorylation
D. Stop respiratory chain
E. Activate oxidative phosphorylation
114. While shifting the gaze to the closely
situated object the refracting power of
eye’s optical mediums will increase by 10
diopters. It results from changing of such
eye structure:
A. Lens
B. Cornea
C. Vitreous body
D. Liquid of the anterior chamber of eye
E. Muscle that dilatates pupil
115. Necrosis focus appeared in the area
of hyperemia and skin edema in few hours
after burn. What mechanism strengthens
destructive effect in the inflammation
area?
A. Secondary alteration
B. Primary alteration
C. Emigration of lymphocytes
D. Diapedesis of erythrocytes
E. Proliferation of fibroblasts
116. Analeptical remedy of reflective type
from the H-cholinomimetics group was
given to the patient for restoration of
breathing after poisoning with carbon
monoxide. What medicine was prescribed
to the patient?
A. Lobeline hydrochloride
B. Atropine sulphate
C. Adrenalin hydrochloride
D. Mesaton
E. Pentamin
117. 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, eosinophi-
ls - 0, myelocytes - 0, juvenile - 0,
stab neutrophils - 20, segmentonuclear
neutrophils - 53, lymphocytes - 21,
monocytes - 5. How is such nuclear shi-
ft of leukocytic formula called?
A. Degenerative left shift
B. Right shift
C. Regenerative left shift
D. Hyperregenerative
E. Regeneratively-degenerative
13
118. A patient has got a spasm of smooth
muscles of bronchi. Activators of what
membrane cytoreceptors are phisiologi-
cally reasoned to stop an attack?
A. β-adrenoreceptors
B. α-аdrenoreceptors
C. α- and β-аdrenoreceptors
D. Н-cholinoreceptors
E. М-cholinoreceptors
119. Intrapleural pressure of an individual
is being measured. In what phase did he
hold his breath if the pressure is - 25 cm
H2 O?
A. Forced inspiration
B. Quiet expiration
C. Quiet inspiration
D. Forced expiration
E. -
120. Blood sampling for the haematology
is recommended to carry out on an
empty stomach and in the morning. What
changes in blood formula are possible if
blood sampling was carried out after food
intake?
A. Increase of leukocyte number
B. Increase of erythrocyte number
C. Increase of plasm proteins
D. Decrease of thrombocyte number
E. Decrease of erythrocyte number
121. Glomerular filtration rate (GFR)
increased by 20% as a result of prolonged
starvation of an individual. The most evi-
dent cause of filtration changes under this
conditions is:
A. Decrease of oncotic pressure of blood
plasma
B. Increase of systemic blood pressure
C. Increase of penetration of the renal
filter
D. Increase of filtration coefficient
E. Increase of renal plasma stream
122. The ovary specimen colored with
hematoxylin-eosin contains a follicle, in
which cubic-shaped follicle epithelium
cells are placed in 1-2 layers, and scarlet
membrane is seen around the ovocyte.
Name this follicle:
A. Primary
B. Primordial
C. Secondary
D. Mature
E. Atretic
123. A 42-year-old man suffering from
 Krok 1 Medicine 2006 14

gout has increased level of urinary acid with acute attack of chronic tonsillitis.
in blood. Allopurinol was prescribed What action of glucocorticoids caused this
to decrease the level of urinary acid. complication?
Competitive inhibitor of what enzyme is
allopurinol? A. Immunosuppressive
B. Anti-inflammatory
A. Xanthine oxidase C. Antishock
B. Adenosine deaminase D. Antiallergic
C. Adenine phosphoribosiltransferase E. Antitoxic
D. Hypoxanthine phosphoribosi-
ltransferase 129. Autopsy of a 12-year-old gi-
E. Guanine deaminase rl revealed: multiple cutaneous
hemmorhages (mostly into the skin of
124. A child has inhaled a button. Where buttocks, lower extremities), serous and
is it likely to be? mucous memrane hemmorhages, cerebral
hemmorhages. Adrenal glands show focal
A. In the right main bronchus necrosis and massive hemmorhages; ki-
B. In the left main bronchus dneys show necrotic nephrosis, suppurati-
C. In the trachea ve arthritis, iridocyclitis, vasculitis. What
D. In the larynx is the most probable diagnosis?
E. In the esophagus
A. Meningococcemia
125. A patient with serious damage of B. Epidemic typhus
muscular tissue was admitted to the C. Periarteritis nodosa
traumatological department. What bi- D. Systemic lupus erythematosus
ochemical urine index will be increased E. Radiation sickness
in this case?
130. A 68-year-old woman can’t move her
A. Creatinine upper and lower right extremities due to
B. Common lipids the stroke. Muscle tone of these extremiti-
C. Glucose es and their reflexes are increased. There
D. Mineral salts are pathological reflexes. What form of
E. Uric acid paralysis is it?
126. Donor skin transplantation was A. Hemiplegia
performed to a patient with extensive B. Paraplegia
burns. On the 8-th day the graft became C. Tetraplegia
swollen and changed colour; on the 11-th D. Monoplegia
day graft rejection started. What cells take E. Dissociation
part in this process?
131. Most participants of Magellan
A. T-lymphocytes expedition to America died from avi-
B. Erythrocytes tominosis. This disease declared itself
C. Basophils by general weakness, subcutaneous
D. Eosinophils hemmorhages, falling of teeth, gingival
E. B-lymphocytes hemmorhages. What is the name of this
127. As a result of craniocerebral trauma avitiminosis?
a patient reveals the following symptoms: A. Scurvy
intention tremor, dysmetry, adiadochoki- B. Pellagra
nesis, dysarthria. What structure of the C. Rachitis
brain is injured? D. Polyneuritis (beriberi)
A. Cerebellum E. Biermer’s anemia
B. Striatum 132. A large-scale reaction with
C. Motor cortex parapertussis and pertussis diagnosticums
D. Pale sphere was made in order to make serologi-
E. Black substance cal diagnostics of the whooping cough.
128. A patient with infectious At the bottom of the test-tubes with di-
mononucleosis had been taking agnosticum of Bordetella parapertussis
glucocorticoids for two weeks. He was a granular sediment formed. What anti-
brought into remission, but he fell ill bodies did this reaction reveal?
 Krok 1 Medicine 2006
A. Agglutinins
B. Precipitins
C. Opsonins
D. Bacteriolysins
E. Antitoxins
133. Part of the DNA chain turned 180
degree as a result of gamma radiation.
What type of mutation took place in the
DNA chain?
A. Inversion
B. Deletion
C. Doubling
D. Translocation
E. Replication
134. While having the dinner the child
choked and aspirated the food. Meavy
cough has started, skin and mucose are
cyanotic, pulse is rapid, respiration is
infrequent, expiration is prolonged. What
disorder of the external respiration has
the child?
A. Stage of expiratory dyspnea on
asphyxia
B. Stage of inspiratory dyspnea on
asphyxia
C. Stenotic respiration
D. Alternating respiration
E. Biot’s respiration
135. A pregnant woman had been havi-
ng toxicosis with severe repeated vomi-
ting for 24 hours. In the end of the day
there appeared tetanic convulsions and
fluid loss. What shift of acid-base state
caused these changes?
A. Excretory alkalosis
B. Gaseous alkalosis
C. Gaseous acidosis
D. Metabolic acidosis
E. Excretory acidosis
136. After a trauma a 44-year-old patient
had a rupture of left palm muscle tendons
and of the superficial blood vessels. After
operation and removal of the most part
of the necrotically changed muscle ti-
ssue the bloodstream was normalized.
What vessels have helped to restore the
bloodstream?
A. Arcus palmaris prof undus
B. Arcus palmaris superf icialis
C. Aa. digitales palmares communes
D. Aa. metacarpeae palmares
E. Aa. perf orantes
137. An 18-year-old patient has enlarged
inguinal lymphnodes, they are painless,
15
thickened on palpation. In the area of
genital mucous membrane there is a
small-sized ulcer with thickened edges
and "laquer"bottom of greyish colour.
What is the most probable diagnosis?
A. Syphilis
B. Tuberculosis
C. Lepra
D. Trophic ulcer
E. Gonorrhea
138. A 45-year-old man applied to the
trauma station because of domestic
shoulder trauma. Objectively: extension,
reduction and pronation functions of the
shoulder are absent. What muscle was
injured?
A. Teres major muscle
B. Subscapular muscle
C. Teres minor muscle
D. Infraspinous muscle
E. Supraspinous muscle
139. Diagnostic scraping was performed
to the woman with dysfunctional uteri-
ne bleeding. Multiple convoluted glands,
ganglially dilated lumens of some glands
were revealed histologically in the scrape.
Name the type of general pathological
process in endometry:
A. Hyperplasia glandulocystica
B. Atrophy
C. Metaplasia
D. Displasia
E. Hypertrophic excrescence
140. Tuberculine was introduced
intracutaneously to the child for
tuberculin test. Marked hyperemia, ti-
ssue infiltration developed on the place
of injection in 24 hours. What mechanism
caused these modifications?
A. Cell cytotoxity
B. Reagin type cytotoxity
C. Antibody cytotoxity
D. Granuloma formation
E. Immunocomplex cytotoxity
141. An intraoperational biopsy of
mammal gland has revealed the signs
of atypical tissue presented by disorder
of parenchyma stroma proportion with
domination of the last, gland structures of
different size and shape, lined with single-
layered proliferative epithelium. What is
the most probable diagnosis?
 Krok 1 Medicine 2006
A. Fibroadenoma
B. Papilloma
C. Noninfiltrative cancer
D. Infiltrative cancer
E. Mastitis
142. A 34-year-old patient was diagnosed
with chronic glomerulonephritis 3 years
ago. Edemata have developed within the
last 6 monthes. What caused the edemata?
A. Proteinuria
B. Hyperproduction of vasopressin
C. Liver dysfunction of protein formation
D. Hyperosmolarity of plasma
E. Hyperaldosteronism
143. An old woman was hospitalized with
acute pain, edema in the right hip joint;
the movements in the joint are limited.
Which bone or part of it was broken?
A. The neck of the thigh
B. The body of the thigh bone
C. Condyle of the thigh
D. Pubic bone
E. Ischial bone
144. Concentration of pyruvate is
increased in the patient’s blood, the most
of which is excreted with urine. What avi-
taminosis has the patient?
A. Avitaminosis 1
B. Avitaminosis E
C. Avitaminosis 3
D. Avitaminosis B6
E. Avitaminosis 2
145. A patient with suspected diphtheria
went through bacterioscopic examinati-
on. Examination of throat swab revealed
rod-shaped bacteria with volutin granules.
What etiotropic preparation should be
chosen in this case?
A. Antidiphtheric antitoxic serum
B. Bacteriophage
C. Diphtheria antitoxin
D. Eubiotic
E. Interferon
146. A patient with diabetes mellitus
experienced loss of consciousness and
convulsions after injection of insulin.
What is the result of biochemical blood
analysis for concentration of the sugar?
A. 1,5 mmol/L
B. 8,0 mmol/L
C. 10,0 mmol/L
D. 3,3 mmol/L
E. 5,5 mmol/L
16
147. A patient working at a chemical
plant was admitted to the toxicologi-
cal department with mercury poisoning.
What medicine should be used?
A. Unithiol
B. Isonitrozin
C. Naloxone
D. Activated carbon
E. Enterosorbent
148. A 63-year-old woman shows
symptoms of rheumatoid arthritis. The
increase of what blood indices could be
the most significant for proving the di-
agnosis?
A. Additive glycosaminoglycans
B. Lipoproteids
C. Acid phosphatase
D. General cholesterol
E. R-glycosidase
149. An autopsy revealed large (1-2 cm)
brownish-red, easy crumbling formations
covering ulcerative defects on the external
surface of the aortic valve. What is the
most likely diagnosis?
A. Polypous-ulcerative endocarditis
B. Recurrent warty endocarditis
C. Acute verrucous endocarditis
D. Fibroplastic endocarditis
E. Diffusive endocarditis
150. A 7-year-old girl has signs
of anemia. Laboratory examinati-
on revealed pyruvate kinase defici-
ency in erythrocytes. What process di-
sturbance plays the main role in anemia
development?
A. Anaerobic glycolysis
B. Oxidative phosphorylation
C. Tissue respiration
D. Peroxide decomposition
E. Aminoacids desamination
151. A 5-year-old child who often fells ill
with respiratory diseases has eczematous
appearances after consumption of some
food products, tendency to prolonged
course of inflammatory processes. What
kind of diathesis can be suspected in this
case?
A. Exudative-catharral
B. Hemmorhagic
C. Arthritism
D. Lymphohypoplastic
E. Asthenic
152. Low level of albumins and fibri-
 Krok 1 Medicine 2006
nogen was detected in the patient’s blood.
Decreased activity of what organelle of
the liver hepatocytes can most probably
cause it?
A. Granular endoplasmatic reticulum
B. Agranular endoplasmatic reticulum
C. Mitochondrions
D. Golgi complex
E. Lysosomes
153. A duodenal content smear of a pati-
ent with indigestion contains protosoa 10-
18 mcm large. They have piriform bodi-
es, 4 pairs of filaments, two symmetrically
located nuclei in the broadened part of
body. What kind of the lowest organisms
is it?
A. Lamblia
B. Dysentery ameba
C. Trichomonas
D. Intestinal ameba
E. Balantidium
154. A 44-year-old woman complains of
common weakness, heart pain, consi-
derable increase of body weigt. Objecti-
vely: moon-like face, hirsutism, AP-
165/100 mm Hg, height - 164 cm, wei-
ght - 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 glucocorticoids
B. Decreased production of thyroidal
hormones
C. Increased production of insulin
D. Decreased production of glucagon
E. Increased production of mineralocorti-
coids
155. After a serious viral infection a 3-
year-old child has repeated vomiting, loss
of consciousness, convulsions. Examinati-
on revealed hyperammoniemia. What
may have caused changes of biochemical
blood indices of this child?
A. Disorder of ammonia neutralization in
ornithinic cycle
B. Activated processes of aminoacids
decarboxylation
C. Disorder of biogenic amines neutrali-
zation
D. Increased purtefaction of proteins in
intestines
E. Inhibited activity of transamination
enzymes
156. Albinos can’t stand sun impact - they
don’t aquire sun-tan but get sunburns. Di-
17
sturbed metabolism of what aminoacid
underlies this phenomenon?
A. Phenilalanine
B. Methionine
C. Tryptophan
D. Glutamic acid
E. Histidine
157. A 25-year-old patient complained of
the decreased vision. Accommodation di-
sorders, dilated pupil, lack of reaction for
the light were revealed on examination.
What muscles function is disturbed?
A. Pupil narrowing muscle, ciliary
B. Pupil dilating muscle, ciliary
C. Inferior oblique muscle, ciliary
D. Lateral rectus muscle, pupil narrowing
E. Pupil narrowing and dilating muscles
158. A patient with continious
bronchopneumonia was admitted to
the therapeutic department. Antibiotic
therapy didn’t give much effect. What
medication for improvement of immune
state should be added to the complex
treatment of this patient?
A. Timaline
B. Analgin
C. Sulfocamphocaine
D. Benadryl
E. Paracetamol
159. Patient with abscess of the cut
wound applied to the traumatological
department. In order to clean the wound
from the pus doctor washed it with 3%
hydrogen peroxide. Foam was absent.
What caused the absence of the drug acti-
vity?
A. Inherited insufficiency of catalase
B. Low concentration H2 O2
C. Inherited insufficiency of erythrocyte
phosphatdehydrogenase
D. Shallow wound
E. Pus in the wound
160. Microspecimen of spinal cord contai-
ns a nucleus that should be analyzed.
Its neurons form motor endings in the
skeletal muscles. What nucleus of spinal
cord is meant?
A. Proper nucleus of the anterior horn
B. Thoracic nucleus
C. Intermediate lateral nucleus
D. Proper nucleus of the posterior horn
E. Proper nucleus of gray substance
161. Patient with injured muscles of
 Krok 1 Medicine 2006
the lower extremities was admitted to
the traumatological department. Due to
what cells is reparative regeneration of
the muscle fibers and restoration of the
muscle function possible?
A. Satellite-cells
B. Myoblasts
C. Myofibroblasts
D. Fibroblasts
E. Myoepithelial cells
162. A 50-year-old patient with typhoid
fever was treated with Levomycetin,
next day his condition became worse,
temperature rose to 39, 60 . What caused
the complication?
A. The effect of endotoxin agent
B. Allergic reaction
C. Irresponsiveness of an agent to the
levomycetin
D. Secondary infection addition
E. Reinfection
163. In the specimen of one of the parts
of respiratory system a tubular organ
was found. It has low epithelium, well
developed muscular tunic, glands and
cartilage are absent. Name this organ:
A. Minor bronchs
B. Trachea
C. Larynx
D. Major bronchs
E. Median bronchs
164. A physician examined a patient
and found inguinal hernia. Through what
anatomic formation does it penetrate into
the skin?
A. Hiatus saphenus
B. Anulus f emoralis
C. Canalis adductorius
D. Lacuna musculorum
E. Anulus inguinalis superf icialis
165. A 40-year-old patient complains of
intensive heartbeats, sweating, nausea, vi-
sual impairment, arm tremor, hypertensi-
on. From his anamnesis: 2 years ago he
was diagnosed with pheochromocytoma.
Hyperproduction of what hormones
causes the given pathology?
A. Catecholamines
B. Aldosterone
C. Glucocorticoids
D. ACTH
E. Thyroidal hormones
166. A 58-year-old patient with acute
18
cardiac insufficiency has decreased
volume of daily urine - oliguria. What is
the mechanism of this phenomenon?
A. Decreased glomerular filtration
B. Decreased number of functioning
glomerules
C. Drop of oncotic blood pressure
D. Rise of hydrostatic blood pressure in
capillars
E. Reduced permeamility of renal filter
167. A 60-year-old man felt asleep after
cerebral hemorrhage for a long time.
Damage of what structure caused this
state?
A. Reticular formation
B. Hippocampus
C. Nuclears of the cerebral nerves
D. Cortex of the large hemispheres
E. Black substance
168. Tuberculosis can be treated by means
of combined chemotherapy that includes
substances with different mechanisms of
action.What antituberculous medication
inhibits transcription of RNA into DNA
in mycobacteria?
A. Rifampicin
B. Isoniazid
C. Streptomycin
D. Ethionamide
E. Para-aminosalicylic acid
169. A patient experienced a sudden
temperature rise up to 390 . After 6 hours
the temperature normalized. On the 2-nd
day the attack recurred: in the period of
paroxysm the temperature reached 410 ,
apyrexial period began after 8 hours.
What type of temperature profile is it?
A. Intermitting
B. Recurrent
C. Hectic
D. Septic
E. Continued
170. Cerebral trauma caused increase
of ammonia formation. What aminoacid
takes part in removal of ammonia from
cerebral tissue?
A. Glutamic
B. Tyrosine
C. Valine
D. Tryptophan
E. Lisine
171. Microscopic examination of the
sputum of a patient with pneumonia
 Krok 1 Medicine 2006
occasionally revealed some larvae. Eosi-
nophiles were detected on blood exami-
nation. What helminthiasis can be di-
agnosed?
A. Ascariasis
B. Enterobiosis
C. Trichocephaliasis
D. Paragonimiasis
E. Opisthorchosis
172. A 40-year-old woman was admitted
to the infectious diseases department wi-
th high body temperature. Objectively:
marked meningeal symptoms. A spinal
cord punction was made. What anatomic
formation was puncturated?
A. Spatium subarachnoideum
B. Spatium subdurale
C. Spatium epidurale
D. Cavum trigeminale
E. Cisterna cerebellomedullaris posterior
173. The energy inputs of a healthy man
have been measured. In what state was
the patient if his energy inputs were less
than the main exchange?
A. Sleep
B. Rest
C. Easy work
D. Nervous exertion
E. Calmness
174. Examination of a newborn boy’s geni-
tals revealed a cleft of urethra that opens
on the inferior surface of his penis. What
developmental anomaly is meant?
A. Hypospadia
B. Hermaphroditism
C. Epispadia
D. Monorchism
E. Cryptorchism
175. To prevent long-term effects of 4-day
malaria a 42-year-old patient was prescri-
bed primaquine. On the 3-rd day from
the begin of treatment there appeared
stomach and heart pains, dyspepsia,
general cyanosis, hemoglobinuria. What
caused side effects of the preparation?
A. Genetic insufficiency of glucose 6-
phosphate dehydrogenase
B. Cumulation of the preparation
C. Decreased activity of microsomal liver
enzymes
D. Delayed urinary excretion of the
preparation
E. Drug potentiation by other preparations
19
176. A 17-year-old boy fell seriously ill,
body temperature rose up to 38, 50 , there
is cough, rhinitis, lacrimation, nasal di-
scharges. What kind of inflammation is
it?
A. Catarrhal inflammation
B. Serous inflammation
C. Fibrinous inflammation
D. Suppurative inflammation
E. Hemorrhagic inflammation
177. A genetics specialist analyzed the
genealogy of a family and found that both
males and females may have the illness,
not across all the generations, and that
healthy parents may have ill children.
What is the type of illness inheritance?
A. Autosomal recessive
B. Autosomal dominant
C. X-linked dominant
D. X-linked recessive
E. Y-linked
178. A patient who has been treated
with diazepam on account of neurosis
complains of toothache. Doctor admi-
nistered him an analgetic, but its dose
was lower than average therapeutic dose.
What phenomenon did the doctor take
into account while prescribing the patient
an underdose?
A. Potentiation
B. Summation
C. Cumulation
D. Drug dependence
E. Tolerance
179. Inflammatory process of modified
subserous layer around cervix of the
uterus caused an intensive pain syndrome.
In what region of genitals does the
pathological process take place?
A. P arametrium
B. Mesometrium
C. Myometrium
D. Endometrium
E. P erimetrium
180. Analysis of amniotic fluid that was
obtained as a result of amniocentesis
(puncture of amniotic sac) revealed cells
the nuclei of which contain sex chromatin
(Barr’s body). What can it be evidence of?
 Krok 1 Medicine 2006
A. Development of female fetus
B. Development of male fetus
C. Genetic disorders of fetus development
D. Trisomy
E. Polyploidy
181. A 2-year-old child has got intesti-
nal dysbacteriosis, which resultsed in
hemorrhagic syndrome. What is the most
likely cause of hemorrhage of the child?
A. Vitamin K deficiency
B. Activation of tissue thromboplastin
C. PP hypovitaminosis
D. Fibrinogen deficiency
E. Hypocalcemia
182. Autopsy of a 46-year-old man
revealed multiple brown-and-green layers
and hemmorhages on the mucous
membrane of rectum and sigmoid colon;
slime and some blood in colon lumen; hi-
stologically - fibrinous colitis. In course of
bacteriological analysis of colon contents
S.Sonne were found. What is the most
probable diagnosis?
A. Dysentery
B. Cholera
C. Salmonellosis
D. Yersiniosis
E. Crohn’s disease
183. A patient had been ill with bronchi-
al asthma for many years and died from
asthmatic fit. Histologic lung examinati-
on revealed: lumen of bronchioles and
small bronches contain a lot of mucus
with some eosinophils, there is sclerosis
of alveolar septums, dilatation of alveole
lumen. What mechanism of development
of hypersensibility reaction took place?
A. Reagin reaction
B. Cytotoxic reaction
C. Immunocomplex reaction
D. Cytolysis determined by lymphocytes
E. Granulomatosis
184. To anaesthetize the surgical
treatment of burn surface, a patient was
intravenously injected a medication for
short-acting narcosis. 1 minute later the
patient being under anaesthesia showed
increased blood pressure, tachycardia,
increased tone of skeletal muscles;
reflexes remained. After recovering from
anaesthesia the patient had disorientation
and visual hallucinations. What medicati-
on was the patient injected?
20
A. Ketamine
B. Sombrevin
C. Diethyl ether
D. Thiopental sodium
E. Nitrous oxide
185. Desulfiram is widely used in medical
practice to prevent alcocholism. It inhi-
bits aldehyde dehydrogenase. Increased
level of what metabolite causes aversion
to alcochol?
A. Acetaldehyde
B. Ethanol
C. Malonyl aldehyde
D. Propionic aldehyde
E. Methanol
186. A 1-year-old child with symptoms of
muscle involvement was admitted to the
hospital. Examination revealed carnitine
deficiency in his muscles. What process di-
sturbance is the biochemical basis of this
pathology?
A. Transporting of fatty acids to mi-
tochodrions
B. Regulation of Ca2+ level in mi-
tochondrions
C. Substrate phosphorylation
D. Lactic acid utilization
E. Actin and myosin synthesis
187. A patient died from acute cardiac
insufficiency. The histological examinati-
on of his heart revealed the necrotized
section in myocardium of the left ventri-
cle, which was separated from undamaged
tissue by the zone of hyperimic vessels,
small hemorrhages and leukocytic infi-
ltration. What is the most likely diagnosis?
A. Myocardial infarction
B. Myocardial ischemic dystrophy
C. Focal exudate myocarditis
D. Diffuse exudate myocarditis
E. Productive myocarditis
188. Kidneys of a man under examinati-
on show increased resorbtion of calci-
um ions and decreased resorbtion of
phosphate ions. What hormone causes
this phenomenon?
A. Parathormone
B. Thyrocalcitonin
C. Hormonal form D3
D. Aldosterone
E. Vasopressin
189. An isolated cell of human heart
automatically generates excitation
impulses with frequency 60 times pro mi-
 Krok 1 Medicine 2006
nute. What structure does this cell belong
to?
A. Sinoatrial node
B. Atrium
C. Ventricle
D. Atrioventricular node
E. His’ bundle
190. While preparing a patient to the
operation the heart chambers’ pressure
was measured. In one of them the
pressure changed during one heart cycle
from 0 to 120 mm Hg. What chamber of
heart was it?
A. Left ventricle
B. Right ventricle
C. Right atrium
D. Left atrium
E. -
191. Part of alveoles of a preterm infant
didn’t spread because of enhanced elastic
recoil of lungs. How can this recoil be
reduced?
A. By surfactant introduction
B. By pure oxygene inhalation
C. By artificial pulmonary ventilation
D. By fluid suction from the respiratory
tracts
E. By glycose introduction
192. A young man has a painlessl formati-
on without marked borders in the soft ti-
ssues of his thigh. On the tissue bioptate
the formation looks like flesh of fish and
consists of immature fibroblast-like cells
with multiple mitosis growing through
the muscles. What is the most likely di-
agnosis?
A. Fibrosarcoma
B. Myosarcoma
C. Fibroma
D. Cancer
E. Myoma
193. In course of prophylactic medi-
cal examination a 7-year-old boy was
diagnosed to have daltonism. Parents
are healthy, color vision is normal. But
grandfather from the mother’s side has
the same disorder. What is the type of
inheriting of this anomaly?
A. Recessive, sex-linked
B. Dominant, sex-linked
C. Incomplete domination
D. Autosomal-recessive
E. Autosomal-dominant
21
194. Objective examination of a patient
revealed: slender figure, big skull, highly
developed frontal region of face, short
extremities. What constitutional type is
it characteristic for?
A. Respiratory
B. Muscular
C. Digestive
D. Cerebral
E. Mixed
195. A 38-year-old patient died during
intractable attack of bronchial asthma.
Histologic examination revealed mucus
accumulation in bronchial lumen, a lot
of fat cells (labrocytes) in the wall of
bronches, many of them are in the state of
degranulation, there are also a lot of eosi-
nophils. What pathogenesis of bronchial
changes is it?
A. Atopy
B. Cytotoxic, cytolytic action of antibodies
C. Immunocomplex mechanism
D. Cellular cytolysis
E. Granulomatosis
196. A patient with thrombophlebitis
of lower extremities had got chest pai-
ns, blood spitting, growing respiratory
failure that caused his death. Autopsy
revealed multiple pulmonary infarctions.
What is the most probable reason of their
development?
A. Pulmonary artery embolism
B. Pulmonary artery thrombosis
C. Bronchial artery thrombosis
D. Bronchial artery embolism
E. Pulmonary venous thrombosis
197. Diabetes mellitus causes ketosis as a
result of activated oxidation of fatty acids.
What disorders of acid-base equilibrium
may be caused by excessive accumulation
of ketone bodies in blood?
A. Metabolic acidosis
B. Metabolic alcalosis
C. Any changes woun’t happen
D. Respiratory acidosis
E. Respiratory alcalosis
198. A 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?
 Krok 1 Medicine 2006 22

A. Recessive epistasis madescence in the region of mammilla, a

B. Codominance small ulcer with inflammatory hyperemia
C. Polymery and cutaneous edema. Histologic exami-
D. Incomplete dominance nation of tissue sampling from this area
E. Complementation revealed in the malpighian layer of thi-
ckened epidermis atypical cells with li-
199. A 30-year-old woman was diagnosed ght and optically empty cytoplasm, with
with insufficiency of exocrinous function no intracellular bridges. Such cells were
of pancreas. Hydrolisis of what nutrients also found in the orifice of big mammal
will be disturbed? gland ducts. What is the most probable di-
A. Proteins, fats, carbohydrates agnosis?
B. Proteins, fats A. Paget’s disease
C. Proteins, carbohydrates B. Intraductal cancer
D. Fats, carbohydrates C. Basal cell carcinoma
E. Proteins D. Epidermoid cancer
200. A 39-year-old woman has E. Melanocarcinoma
 Krok 1 Medicine 2007
1. A patient had to go through an
operation. Doctors introduced him di-
thylinum (listenone) and performed
intubation. After the end of operati-
on and cessation of anesthesia the
independent respiration wasn’t restored.
Which enzyme deficit prolongs the action
of muscle relaxant?
A. Pseudocholinesterase
B. Succinate dehydrogenase
C. Carbanhydrase
D. N-acetyltransferase
E. K-Na-adenosine triphosphatase
2. A patient is ill with diabetes mellitus
that is accompanied by hyperglycemia of
over 7,2 millimole/l on an empty stomach.
The level of what blood plasma protein
allows to estimate the glycemia rate
retrospectively (4-8 weeks before exami-
nation)?
A. Glycated hemoglobin
B. Albumin
C. Fibrinogen
D. C-reactive protein
E. Ceruloplasmin
3. A 60 y.o. patient has a reduced percepti-
on of high-frequency sounds. What
structures’ disorder of auditory analizer
caused these changes?
A. Main membrane of cochlea near the
oval window
B. Main membrane of cochlea near heli-
cotrema
C. Eustachian tube
D. Muscles of middle ear
E. Tympanic membrane
4. A patient ill with diabetes mellitus
felt acute pain in his right foot. Objecti-
vely: foot thumb is black, foot tissues are
edematous, there are foci of epidermis
desquamation, stinking discharges. What
clinicopathological form of necrosis is it?
A. Moist gangrene
B. Bedsore
C. Sequestrum
D. Dry gangrene
E. Infarction
5. A patient with a stab wound of the
anterior stomach wall is in surgical care.
What formation of abdominal cavity did
the stomach contents get into?
1
A. Antegastrial bursa
B. Omental bursa
C. Hepatic bursa
D. Left mesenteric sinus
E. Right mesenteric sinus
6. A 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 of edemata
development:
A. Reduced synthesis of albumins
B. Reduced synthesis of globulins
C. Reduced synthesis of hemoglobin
D. Reduced synthesis of lipoproteins
E. Reduced synthesis of glycoproteins
7. Autopsy of a patient who suffered
from croupous pneumonia and died from
pneumococcal sepsis revealed 900 ml of
turbid greenish-yellow liquid in the ri-
ght pleural cavity. Pleural leaves are dull,
plephoric. Name the clinicopathological
form of inflammation in the pleural cavity:
A. Empyema
B. Fibrinous inflammation
C. Phlegmon
D. Chronic abscess
E. Acute abscess
8. Examination of a patient revealed
reduced contents of magnesium ions that
are necessary for attachment of ribosomes
to the granular endoplasmatic reticulum.
It is known that it causes disturbance
of protein biosynthesis. What stage of
protein biosynthesis will be disturbed?
A. Translation
B. Transcription
C. Replication
D. Aminoacid activation
E. Termination
9. Analysis of blood serum of a
patient revealed increase of alanine
aminotransferase and aspartate ami-
notransferase level. What cytological
changes can cause such a situation?
A. Cellular breakdown
B. Disturbed function of energy supply of
cells
C. Disorder of enzyme systems of cells
D. Disturbance of genetic apparatus of
cells
E. Disturbance of cellular interrelations
10. Power inputs of a boy increased from
500 to 2000 kJ pro hour. What can be the
 Krok 1 Medicine 2007
cause of it?
A. Physical exercise
B. Raise of outer temperatute
C. Mental activity
D. Food intake
E. Transition from sleep to wakefulness
11. A patient presents high activity
of LDH1,2 , aspartate aminotransferase,
creatine phosphokinase. In what organ
(organs) is the development of a
pathological process the most probable?
A. In the heart muscle (initial stage of
myocardium infarction)
B. In skeletal muscles (dystrophy, atrophy)
C. In kidneys and adrenals
D. In connective tissue
E. In liver and kidneys
12. According to the data of WHO, for
about 250 mln of Earth population fall ill
with malaria. This disease is mostly spread
in tropical and subtropical regions. Range
of its spread falls into the areal of the
following mosquitoes:
A. Anopheles
B. Culex
C. Aedes
D. Mansonia
E. Culiseta
13. Autopsy of a 58 y.o. man revealed that
bicuspid valve was deformed, thickened
and unclosed. Microscopically: foci of
collagen fibrilla are eosinophilic, react
positively to fibrin. The most probably it
is:
A. Fibrinoid swelling
B. Fibrinous inflammation
C. Mucoid swelling
D. Hyalinosis
E. Amyloidosis
14. Labeled aminoacids alanine and
tryptophane were introducted to a mouse
in order to study localization of protein
biosynthesis in its cells. Around what
organellas will the accumulation of
labeled aminoacids be observed?
A. Ribosomes
B. Agranular endoplasmic reticulum
C. Cell centre
D. Lysosomes
E. Golgi apparatus
15. In some regions of South Africa there
is a spread sickle-shaped cell anemia, in
which erythrocytes have shape of a sickle
2
as a result of substitution of glutamin by
valine in the hemoglobin molecule. What
is the cause of this disease?
A. Gene mutation
B. Disturbance of mechanisms of genetic
information realization
C. Crossingover
D. Genomic mutations
E. Transduction
16. A patient died under conditions
of cardiovascular insufficiency. Autopsy
results: postinfarction cardiosclerosis,
myocardium hypertrophy and dilatati-
on of its cavities, especially of its right
ventricle. Liver is enlarged, its surface
is smooth, incision revealed that it was
plethoric, with dark-red specks against
the background of brownish tissue. Hi-
stologically: plethora of central parts of
lobules; peritheral parts around portal
tracts contain hepatocytes in a state of
adipose degeneration. How are these li-
ver changes called?
A. Nutmeg liver
B. Pseudonutmeg liver
C. Amyloidosis
D. Liver cirrhosis
E. Liver steatosis
17. Autopsy of a man who died from
chronic cardiovascular collapse revealed
"tiger heart". Sidewards of endocardium
a yellowish-white banding can be seen;
myocardium is dull, dark-yellow. What
process caused this pathology?
A. Fatty parenchymatous degeneration
B. Carbohydrate degeneration
C. Hyaline degeneration
D. Fatty vascular-stromal degeneration
E. Amyloidosis
18. In course of an experiment a skeletal
muscle is being stimulated by a series of
electric impulses. What type of muscle
contraction will arise, if every subsequent
impulse comes in the period of shortening
of the previous single muscle contraction?
A. Holotetanus
B. Partial tetanus
C. Asynchronous tetanus
D. A series of single contractions
E. Muscle contracture
19. Ammonia is a very toxic substance,
especially for nervous system. What
substance takes the most active part in
ammonia detoxication in brain tissues?
 Krok 1 Medicine 2007
A. Glutamic acid
B. Lysine
C. Proline
D. Histidine
E. Alanine
20. A man was admitted to the hospital
on the 5th day of disease that manifested
itself by jaundice, muscle aching, chill,
nose bleedings. In course of laboratory di-
agnostics a bacteriologist performed dark-
field microscopy of the patient’s blood
drop. Name a causative agent of this di-
sease:
A. Leptospira interrogans
B. Borrelia dutlonii
C. Calymmatobacterium granulomatis
D. Bartonella bacillof ormis
E. Rickettsia mooseri
21. A patient has a transverse disrupti-
on of spinal cord below the IV thoracic
segment. What changes of respiration will
it cause?
A. Respiration will stay unchanged
B. Respiration will stop
C. Respiration will become less frequent
D. Respiration will become deeper
E. Respiration will become more frequent
22. 12 hours after an accute attack of
retrosternal pain a patient presented a
jump of aspartate aminotransferase activi-
ty in blood serum. What pathology is this
deviation typical for?
A. Myocardium infarction
B. Viral hepatitis
C. Collagenosis
D. Diabetes mellitus
E. Diabetes insipidus
23. A lightly dressed man is standing in a
room, air temperature is +140 C, windows
and doors are closed. In what way does he
emit heat the most actively?
A. Heat radiation
B. Heat conduction
C. Convection
D. Evaporation
E. Perspiration
24. A 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. Provi-
sional diagnosis is rheumatoid arthri-
tis. One of the most probable causes of
this disease is a structure alteration of a
connective tissue protein:
3
A. Collagen
B. Mucin
C. Myosin
D. Ovoalbumin
E. Troponin
25. A patient with infectious mononucleosis
has been taking glucocorticoids for two
weeks. He was brought into remission,
but he fell ill with acute attack of chronic
tonsillitis. What action of glucocorticoids
caused this complication?
A. Immunosuppressive
B. Anti-inflammatory
C. Antishock
D. Antiallergic
E. Antitoxic
26. A peripheral segment of vagus nerve
on a dog’s neck was being stimulated in
course of an experiment. The followi-
ng changes of cardiac activity could be
meanwhile observed:
A. Heart rate fall
B. Heart hurry
C. Enhancement of atrioventricular
conduction
D. Heart rate and heart force amplification
E. Increased excitability of myocardium
27. As 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. Lactate
B. Pyruvate
C. 1,3-bisphosphoglycerate
D. 3-phosphoglycerate
E. -
28. A patient was delivered to the hospi-
tal 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 -
20,1 micromole/l (standard is 3,3-5,5 mi-
cromole/l), urine glucose - 3,5% (standard
is - 0). What is the most probable di-
agnosis?
A. Hyperglycemic coma
B. Hypoglycemic coma
C. Acute heart failure
D. Acute alcoholic intoxication
E. Anaphylactic shock
 Krok 1 Medicine 2007
29. A 62 y.o. woman complains of frequent
pains in the area of her chest and
backbone, rib fractures. A doctor assumed
myelomatosis (plasmocytoma). What of
the following laboratory characteristi-
cs will be of the greatest diagnostical
importance?
A. Paraproteinemia
B. Hyperalbuminemia
C. Proteinuria
D. Hypoglobulinemia
E. Hypoproteinemia
30. Nappies of a newborn have dark spots
that witness of formation of homogenti-
sic acid. Metabolic imbalance of which
substance is it connected with?
A. Thyrosine
B. Galactose
C. Methionine
D. Cholesterine
E. Tryptophane
31. Having helped to eliminate
consequences of a failure at a nuclear
power plant, a worker got an irradiati-
on doze of 500 roentgen. He complai-
ns of headache, nausea, dizziness. What
changes in leukocytes quantity can be
expected 10 hours after irradiation?
A. Neutrophilic leukocytosis
B. Lymphocytosis
C. Leukopenia
D. Agranulocytosis
E. Leukemia
32. A 12 y.o. boy who suffers from bronchi-
al asthma has an acute attack of asthma:
evident expiratory dyspnea, skin pallor.
What type of alveolar ventilation di-
sturbance is it?
A. Obstructive
B. Restrictive
C. Throracodiaphragmatic
D. Central
E. Neuromuscular
33. A woman who has been keepi-
ng to a clean-rice diet for a long time
was diagnosed with polyneuritis (beri-
beri). What vitamin deficit results in
development of this disease?
A. Thiamine
B. Ascorbic acid
C. Pyridoxine
D. Folic acid
E. Riboflavin
4
34. Removal of gall bladder of a patient
has disturbed processes of Ca absorption
through the intestinal wall. What vitamin
will stimulate this process?
A. D3
B. P P
C. C
D. B12
E. K
35. A hepatitis outbreak was registered in
a settlement. This episode is connected wi-
th water factor. What hepatitis virus could
have caused the infective outbreak in this
settlement?
A. E
B. C
C. D
D. G
E. B
36. Examination of a 43 y.o. patient
revealed that his stomach has difficulti-
es with digestion of protein food. Gastric
juice analysis revealed low acidity. Functi-
on of which gastric cells is disturbed in this
case?
A. Parietal exocrinocytes
B. Main exocrinocytes
C. Mucous cells (mucocytes)
D. Endocrinous cells
E. Cervical mucocytes
37. A 16 y.o. boy from a countryside
entered an educational establishment.
Scheduled Manteux test revealed that the
boy had negative reaction. What are the
most reasonable actions in this case?
A. To perform BCG vaccination
B. To repeat the reaction in a month
C. To perform serodiagnostics of
tuberculosis
D. To isolate the boy temporarily from his
mates
E. To perform rapid Price diagnostics
38. A patient complains of frequent di-
arrheas, 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?
 Krok 1 Medicine 2007
A. Obturation of biliary tracts
B. Mucous membrane inflammation of
small intestine
C. Lack of pancreatic lipase
D. Lack of pancreatic phospholipase
E. Unbalanced diet
39. A patient consulted a doctor about
bowels disfunction. The doctor establi-
shed symptoms of duodenitis and enteri-
tis. Laboratory examination helped to
make the following diagnosis: lambliosis.
What medication should be administered?
A. Metronidazole
B. Erythromycin
C. Monomycin
D. Chingamin
E. Tetracycline
40. A group of mountain climbers went
through the blood analysis at the hei-
ght of 3000 m. It revealed decrease of
HCO3 to 15 micromole/l (standard is 22-
26 micromole/l). What is the mechanism
of HCO3 decrease?
A. Hyperventilation
B. Intensification of acidogenesis
C. Hypoventilation
D. Decrease of ammoniogenesis
E. Decrease of bicarbonate reabsorption
in kidneys
41. Introduction of a pharmaceutical
substance to an experimental animal
resulted in reduction of salivation, pupil
mydriasis. Next intravenous introduction
of acetylcholine didn’t lead to any signi-
ficant changes of heart rate. Name this
substance:
A. Atropine
B. Adrenaline
C. Propranolol
D. Proserin
E. Salbutamol
42. Continious taking of a drug can
result in osteoporosis, erosion of
stomach mucous membrane, hypokali-
emia, retention of sodium and water,
reduced content of corticotropin in blood.
Name this drug:
A. Prednisolone
B. Hydrochlorothiazide
C. Digoxin
D. Indometacin
E. Reserpine
43. A child is languid, apathetic. Liver
is enlarged and liver biopsy revealed a
5
significant excess of glycogene. 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 liver
B. Low (absent) activity of hexokinase
C. High activity of glycogen synthetase
D. Low (absent) activity of glucose 6-
phosphatase
E. Deficit of a gene that is responsible
for synthesis of glucose 1-phosphaturidine
transferase
44. A 63 y.o. man with collapse symptoms
was delivered to the emergency hospital.
A doctor chose noradrenaline in order to
prevent hypotension. What is the action
mechanism of this medication?
A. Activation of α1 -adrenoreceptors
B. Activation of serotonin receptors
C. Activation of β-adrenoreceptors
D. Activation of dopamine receptors
E. Block of M-cholinoreceptors
45. From pharynx of a child with
suspected diphtheria a pure culture
of microorganisms was isolated. Their
morphological, tinctorial, cultural and bi-
ochemical properties appeared to be typi-
cal for diphtheria causative agents. What
study should be conducted in order to
drow a conclusion that this is a pathogenic
diphtheria bacillus?
A. Estimation of toxigenic properties
B. Estimation of proteolytic properties
C. Estimation of urease activity
D. Estimation of cystinous activity
E. Estimation of ability to decompose
starch
46. Examination of a child revealed some
whitish spots looking like coagulated milk
on the mucous membrane of his cheeks
and tongue. Analysis of smears revealed
gram-positive oval yeast-like cells. What
causative agents are they?
A. Candida
B. Staphylococci
C. Diphtheria bacillus
D. Actinomycetes
E. Fusobacteria
47. 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
mm Hg, depression. This condition is
caused by intensified excretion with uri-
 Krok 1 Medicine 2007 6

ne of: tamin absence caused disturbance of their

hydroxylation?
A. Potassium
B. Sodium A. Vitamin C
C. Chlorine B. Vitamin K
D. Calcium C. Vitamin A
E. Phosphates D. Thiamine
E. Vitamin E
48. After intake of rich food a patient
feels nausea and sluggishness; with ti- 53. A patient who suffers from pneumonia
me there appeared signs of steatorrhea. has high body temperature. What biologi-
Blood cholesterine concentration is 9,2 cally active substance plays the leading
micromole/l. This condition was caused part in origin of this phenomenon?
by lack of:
A. Interleukin-I
A. Bile acids B. Histamine
B. Triglycerides C. Bradykinin
C. Fatty acids D. Serotonin
D. Phospholipids E. Leukotrienes
E. Chylomicrons
54. A 27 y.o. patient put eye drops
49. Examination of a man who hadn’t that contain penicillin. After a few mi-
been consuming fats but had been getti- nutes she felt itching and burning of
ng enough carbohydrates and proteins her body, there appeared lip and eye-lid
for a long time revealed dermatitis, poor edemata; arterial pressure began to drop.
wound healing, vision impairment. What What immunoglobulins took part in the
is the probable cause of metabolic di- development of this allergic reaction?
sorder?
A. lgE and lgG
A. Lack of linoleic acid, vitamins A, D, E, B. IgM and IgG
K C. IgA and IgM
B. Lack of palmitic acid D. IgM and IgD
C. Lack of vitamins P P , H E. IgG and IgD
D. Low caloric value of diet
E. Lack of oleic acid 55. A patient suffers from hepatic ci-
rrhosis. Examination of which of the
50. An experimental animal has been gi- following substances excreted by urine
ven excessive amount of carbon-labeled can characterize the state of antitoxic
glucose for a week. What compound can function of liver?
the label be found in?
A. Hippuric acid
A. Palmitic acid B. Ammonium salts
B. Methionine C. Kreatinine
C. Vitamin A D. Uric acid
D. Choline E. Aminoacids
E. Arachidonic acid
56. A 2 y.o. child has convulsions as a
51. RNA that contains AIDS virus result of lowered concentration of calci-
penetrated into a leukocyte and by means um ions in blood plasma. It is caused by
of reverse transcriptase forced a cell to reduced function of:
synthetize a viral DNA. This process is
based upon: A. Parathyroid glands
B. Hypophysis
A. Reverse transcription C. Adrenal cortex
B. Operon repression D. Pineal gland
C. Reverse translation E. Thymus
D. Operon depression
E. Convariant replication 57. Inflammation of a patient’s eye was
accompanied by accumulation of turbid
52. Examination of a patient with frequent liquid with high protein at the bottom
hemorrhages from internals and mucous of anterior chamber that was called
membranes revealed proline and lysine hypopyon. What process underlies the
being a part of collagene fibers. What vi- changes under observation?
 Krok 1 Medicine 2007 7

A. Disturbance of microcirculation A. HIV infection

B. Primary alteration B. Being ill with AIDS
C. Secondary alteration C. Being infected with HBV
D. Proliferation D. Having had AIDS recently
E. - E. HBV persistence
58. Heart rate of a man permanently 63. Parents of a 10 y.o. boy consulted a
equals 40 beats pro minute. What is the doctor about extension of hair-covering,
pacemaker? growth of beard and moustache, low voi-
ce. Intensified secretion of which hormone
A. Atriventricular node must be assumed?
B. Sinoatrial node
C. His’ bundle A. Of testosterone
D. His’ bundle branches B. Of somatotropin
E. Purkinje’s fibers C. Of oestrogen
D. Of progesterone
59. A 48 y.o. patient was admitted to the E. Of cortisol
hospital with complaints about weakness,
irritability, sleep disturbance. Objectively: 64. A patient who suffers from severe di-
skin and scleras are yellow. In blood: sorder of water-salt metabolism experi-
conjugated bilirubin, cholalemia. Feces enced cardiac arrest in diastole. What is
are acholic. Urine is of dark colour (bi- the most probable mechanism of cardiac
lirubin). What jaundice is it? arrest in diastole?
A. Mechanic A. Hyperkaliemia
B. Hemolytic B. Hypernatremia
C. Parenchymatous C. Organism dehydratation
D. Gilbert’s syndrome D. Hypokaliemia
E. Crigler-Najjar syndrome E. Hyponatremia
60. Bacteriological examination of a 65. Examination of coronary arteries
patient with food poisoning required revealed atherosclerotic calcific plaques
inoculation of a pure culture of bacteria that close vessel lumen by 1/3. The muscle
with the following properties: gram- has multiple whitish layers of connecti-
negative movable bacillus that grows in ve tissue. What process was revealed in
the Endo’s medium in form of colourless myocardium?
colonies. A representative of which speci-
es caused this disease? A. Diffuse cardiosclerosis
B. Tiger heart
A. Salmonella C. Postinfarction cardiosclerosis
B. Shigella D. Myocarditis
C. Iersinia E. Myocardium infarction
D. Esherichia
E. Citrobacter 66. Reaction of passive hemagglutinati-
on conducted with erythrocytic typhoid
61. A patient was diagnosed with active Vi-diagnosticum helped to reveal some
focal pulmonary tuberculosis. What drug antibodies in the dilution of the patient’s
should be prescribed in the first place? serum at a ratio of 1:80 that exceeds the
diagnostic titer. Such result witnesses of:
A. Isoniazid
B. Sulfalen A. Being a potential carrier of typhoid
C. Cyclocerine bacilli
D. Ethionamide B. Being ill with acute typhoid fever
E. Ethoxide C. Typhoid fever recurrence
D. Incubation period of typhoid fever
62. Examination of a young man in the E. Reconvalescence of a patient ill with
AIDS centre produced a positive result typhoid fever
of immune-enzyme assay with HIV anti-
gens. Patient’s complaints about state of 67. A teenager was irradiated with hi-
his health were absent. What can the posi- gh radiation dose that resulted in seri-
tive result of immune-enzyme assay be ous damages of lymphoid system, lysis of
evidence of? many lymphocytes. Restoration of normal
 Krok 1 Medicine 2007
hemogram is possible due to the functi-
oning of the following gland:
A. Thymus
B. Thyroid
C. Liver
D. Pancreas
E. Adrenal
68. A man with cut wound of his right
foot sole was admitted to the hospital
ward. The patient has limited elevati-
on of the lateral foot edge. In course
of wound management the injury of a
muscle tendon was revealed. What muscle
is injured?
A. Long peroneal
B. Anterior tibial
C. Long extensor muscle of toes
D. Triceps muscle of crus
E. Short peroneal
69. A patient who suffers from heart fai-
lure has enlarged liver, edemata of lower
extremities, ascites. What is the leading
mechanism in the development of this
edema?
A. Hydrodynamic
B. Colloid osmotic
C. Lymphogenous
D. Membranogenic
E. -
70. A 32 y.o. man is tall, he has
gynecomastia, adult woman pattern of
hair distribution, high voice, mental defici-
ency, sterility. Provisional diagnosis is Kli-
nefelter’s syndrome. In order to specify
diagnosis it is necessary to analize:
A. Caryotype
B. Leukogram
C. Spermatogenesis
D. Blood group
E. Genealogy
71. Examination of a miner revealed
pulmonary fibrosis accompanied by di-
sturbance of alveolar ventilation. What is
the main mechanism of this disturbance?
A. Limitation of respiratory surface of
lungs
B. Constriction of superior respiratory
tracts
C. Disturbance of neural respiration
control
D. Limitation of breast mobility
E. Bronchi spasm
72. A man took a quiet expiration. Name
8
an air volume that is meanwhile contained
in his lungs:
A. Functional residual capacity
B. Residual volume
C. Expiratory reserve volume
D. Respiratory volume
E. Vital lung capacity
73. Examination of an isolated cardi-
omyocyte revealed that it didn’t generate
excitation impulses automatically. This
cardiomyocyte was obtained from:
A. Ventricles
B. Sinoatrial node
C. Atrioventricular node
D. His’ bundle
E. Purkinje’s fibers
74. Examination of a man established that
cardiac output equaled 3500 ml, systolic
output - 50 ml. What is the man’s heart
rate pro minute?
A. 70
B. 60
C. 50
D. 80
E. 90
75. A man who went for a ride on a
roundabout had amplification of heart
rate, sweating and nausea. What receptors
stimulation is it primarily connected with?
A. Vestibular
B. Proprioceptors
C. Tactors
D. Auditory
E. Visual
76. In order to estimate toxigenity of di-
phtheria agents obtained from patients
the cultures were inoculated on Petri dish
with nutrient agar on either side of a filter
paper strip that was put into the centre
and moistened with antidiphtheric anti-
toxic serum. After incubation of inoculati-
ons in agar the strip-like areas of medium
turbidity were found between separate
cultures and the strip of filter paper. What
immunological reaction was conducted?
A. Precipitation gel reaction
B. Coomb’s test
C. Agglutination reaction
D. Rings precipitation reaction
E. Opsonization reaction
77. A man’s intrapleural pressure is being
measured. In what phase did the man hold
his breath, if his pressure is 7,5 cm Hg?
 Krok 1 Medicine 2007
A. Quiet inspiration
B. Quiet expiration
C. Forced inspiration
D. Forced expiration
E. -
78. A 49 y.o. woman consulted a doctor
about heightened fatigue and dyspnea
during physical activity. ECG: heart
rate is 50/min, PQ is extended, QRS
is unchanged, P wave quanity exceeds
quantity of QRS complexes. What type
of arrhythmia does the patient have?
A. Atrioventricular block
B. Extrasystole
C. Sinus bradycardia
D. Ciliary arhythmia
E. Sinoatrial block
79. A patient with neuritis of femoral
nerve has disturbed flexion of thigh as well
as disturbed crus extension in the knee joi-
nt. What muscle’s function is disturbed?
A. Quadriceps muscle of thigh
B. Biceps muscle of thigh
C. Triceps muscle of thigh
D. Semitendinous muscle
E. Semimembranous muscle
80. Autopsy of a newborn boy revealed
polydactylia, microcephalia, cheiloschisis
and uranoschisis as well as hypertrophy
of parenchimatous organs. These defects
correspond with the description of Patau’s
syndrome. What is the most probable
cause of this pathology?
A. Trisomy of the 13th chromosome
B. Trisomy of the 18th chromosome
C. Trisomy of the 21st chromosome
D. Nondisjunction of sex chromosomes
E. Partial monosomy
81. An ovary specimen stained by
hematoxylin-eosin presents a follicle,
where cells of follicular epithelium are
placed in 1-2 layers and have cubic form,
there is a bright-red membrane around
the ovocyte. What follicle is it?
A. Primary
B. Primordial
C. Secondary
D. Mature
E. Atretic
82. A woman has been applying a
new cosmetic preparation for a week
that resulted in eye-lid inflammation
accompanied by hyperemia, infiltration
9
and painfulness. What type of allergic
reaction was developed?
A. IV
B. I
C. II
D. III
E. V
83. Examination of a patient revealed
extremely myotic pupils, sleepiness,
infrequent Chain-Stoke’s respiration, uri-
nary retention, slowing-down of heart
rate, enhancement of spinal reflexes. What
substance caused the poisoning?
A. Morphine
B. Atropine
C. Phosphacole
D. Caffeine
E. Barbital
84. A patient is followed up in an
endocrinological dispensary on account of
hyperthyreosis. Weight loss, tachycardia,
finger tremor are accompanied by hypoxia
symptoms - headache, fatigue, eye flicker.
What mechanism of thyroid hormones
action underlies the development of
hypoxia?
A. Disjunction, oxydation and phosphori-
lation
B. Inhibition of respiratory ferment
synthesis
C. Competitive inhibition of respiratory
ferments
D. Intensification of respiratory ferment
synthesis
E. Specific binding of active centres of
respiratory ferments
85. A doctor administered a patient with
allergic dermatitis a H1 -histamine blocker
as a part of complex treatment. Name this
medication:
A. Loratadine
B. Cromolyn sodium
C. Prednisolone
D. Adrenaline
E. Hydrocortisone
86. An injured man has bleeding
from branches of carotid artery. For
a temporary arrest of bleeding it is
necessary to press the carotid artery to
the tubercle of a cervical vertebra. Which
vertebra is it?
 Krok 1 Medicine 2007
A. VI
B. V
C. IV
D. III
E. II
87. As a result of an accident a patient
has intense painfullness and edema of the
anterior crus surface; dorsal flexion of foot
is hindered. Function of which crus muscle
is most likely to be disturbed?
A. M.tibialis anterior
B. M.f lexor digitorum longus
C. M.f lexor hallucis longus
D. M.peroneus longus
E. M.peroneus brevis
88. The first grade pupils were exami-
ned in order to sort out children for
tuberculosis revaccination. What test was
applied for this purpose?
A. Mantoux test
B. Schick test
C. Supracutaneous tularin test
D. Burnet test
E. Anthraxine test
89. The permeability of the irritable cell
membrane has been increased for potassi-
um ions during an experiment. What
changes of membrane electric status can
occur?
A. Hyperpolarization
B. Depolarization
C. Action potential
D. Local response
E. No changes
90. A patient with II stage hypertensi-
on has been taking one of hypotensive
medications for the purpose of treatment.
After a time arterial pressure decreased,
but the patient started complaining of
flaccidity, sleepiness, indifference. A bit
later he felt stomach pain. He was di-
agnosed with ulcer. What hypotensive
medication has the patient been taking?
A. Reserpine
B. Dibazole
C. Furosemide
D. Verapamil
E. Captopril
91. 6 months after delivery a woman had
uterine bleeding. Gynecological exami-
nation revealed in the uterine cavity a
dark-red tissue with multiple cavities
that resembled of "sponge". Microscopic
examination of the tumour revealed some
10
atypic light epithelial Langhans cells and
giant cells of cyncytiotrophoblast in blood
lacunas. What tumour is it?
A. Chorioepithelioma
B. Squamous cell nonkeratinous carci-
noma
C. Adenocarcinoma
D. Fibromyoma
E. Vesicular mole
92. A 40 y.o. patient complains of intensi-
ve heartbeats, sweating, nausea, visi-
on impairment, arm tremor, hypertensi-
on. From his anamnesis: 2 years ago he
was diagnosed with pheochromocytoma.
Hyperproduction of what hormones
causes the given pathology?
A. Catecholamines
B. Aldosterone
C. Glucocorticoids
D. ACTH
E. Thyroid hormones
93. A 56 y.o. patient has been suffering
from thyreotoxicosis for a long time. What
type of hypoxia can be developed?
A. Tissue
B. Hemic
C. Circulatory
D. Respiratory
E. Mixed
94. A sportsman was recommended to
take a medication that contains carniti-
ne in order to improve his results. What
process is activated by carnitine the most?
A. Fatty acids transport to mitochondrions
B. Synthesis of steroid hormones
C. Synthesis of ketone bodies
D. Synyhesis of lipids
E. Tissue respiration
95. A patient has symptoms of inflammati-
on of urogenital tracts. Examination of a
vaginal smear revealed big monocellular,
pear-shaped organisms with the pointed
spike at the posterior end of body, big
nucleus and undulating membrane. What
protozoa were found in the smear?
A. T richomonas vaginalis
B. T richomonas hominis
C. T richomonas buccalis
D. T rypanosoma gambiense
E. Lamblia intestinalis
96. A patient has extrasystole. ECG shows
no P wave, QRS complex is deformed,
there is a full compensatory pause. What
 Krok 1 Medicine 2007
extrasystoles are these?
A. Ventricular
B. Atrial
C. Atrioventricular
D. Sinus
E. -
97. A patient who suffers from cancer of
back of tongue has an intense bleeding
as a result of affection of dorsal lingual
artery by the tumour. What vessel should
be ligated to stop bleeding?
A. Lingual artery
B. Dorsal lingual artery
C. Deep lingual artery
D. Facial artery
E. Ascending pharyngeal artery
98. In course of an experiment a big
number of stem cells of red bone marrow
was in some way destructed. Regenerati-
on of which cell populations in the loose
connective tissue will be inhibited?
A. Of macrophags
B. Of fibroblasts
C. Of pigment cells
D. Of lipocytes
E. Of pericytes
99. Histological examination of a 40
y.o. man’s thymus revealed decreased
share of parenchymatous gland elements,
increased share of adipose and loose
connective tissue, its enrichment with
thymus bodies. The organ’s mass was
unchanged. What phenomenon is it?
A. Age involution
B. Accidental involution
C. Hypotrophy
D. Dystrophy
E. Atrophy
100. Mucous membrane of the right
palatine tonsil has a painless ulcer wi-
th smooth lacquer fundus and regular
cartilagenous edges. Microscopically:
inflammatory infiltration that consists
of lymphocytes, plasmocytes, a small
number of neutrophils and epithelioid
cells; endovasculitis and perivasculitis.
What disease is it?
A. Syphilis
B. Actinomycosis
C. Tuberculosis
D. Pharyngeal diphtheria
E. Ulcerous necrotic Vincent’s angina
101. Bacteriological laboratory examines
11
canned meat whether it contains botuli-
num toxin. For this purpose an extract of
test specimen and antitoxic antibotulinic
serum of A, B, E types were introducted
to a group of mice under examination; a
control group of mice got the extract wi-
thout antibotulinic serum. What serologi-
cal reaction was applied?
A. Neutralization
B. Precipitation
C. Complement binding
D. Opsono-phagocytic
E. Double immune diffusion
102. To prevent postoperative bleeding
a 6 y.o. child was administered vicasol
that is a synthetic analogue of vitamin K.
Name post-translational changes of blood
coagulation factors that will be activated
by vicasol:
A. Carboxylation of glutamin acid
B. Phosphorylation of serine radicals
C. Partial proteolysis
D. Polymerization
E. Glycosylation
103. As a result of spinal-cord trauma
a 33 y.o. man has a disturbed pain and
temperature sensitivity that is caused by
damage of the following tract:
A. Spinothalamic
B. Medial spinocortical
C. Posterior spinocerebellar
D. Lateral spinocortical
E. Anterior spinocerebellar
104. For the preparation of a patient’s
burn skin surface a certain medication was
used. Its antiseptic action is provided by
free oxygen that segregates in presence
of organic substances. Choose the right
answer:
A. Potassium permanganate
B. Furacilin
C. Chlorhexidine
D. Boric acid
E. Sodium bicarbonate
105. After a 2 y.o. child has had flu, there
appeared complaints about ear ache. A
doctor revealed hearing impairment and
inflammation of the middle ear. How did
the infection penetrate into the middle
ear?
 Krok 1 Medicine 2007
A. Through the auditory tube
B. Through f oramen jugularis
C. Through canalis caroticus
D. Through atrium mastoideum
E. Through canalis nasolacrimalis
106. A 50 y.o. patient with chronic cardi-
ac insufficiency and tachyarrythmia was
prescribed a cardiotonic drug. What drug
was prescribed?
A. Digoxin
B. Dopamine
C. Dobutamine
D. Amyodarone
E. Mildronate
107. Microscopical examination of a
removed appendix revealed an edema, di-
ffuse neutrophilic infiltration of appendix
wall along with necrosis and defect of
mucous membrane with affection of its
muscle plate. What appendicitis form was
developed?
A. Ulcerophlegmonous
B. Phlegmonous
C. Gangrenous
D. Superficial
E. Apostematous
108. A 39 y.o. woman went through an
operation in course of which surgeons
removed her uterine tube that was
enlarged and a part of an ovary with a big
cyst. Histological examination of a tube
wall revealed decidual cells, chorion vi-
lli. What was the most probable diagnosis
made after examination of the uterine
tube?
A. Tubal pregnancy
B. Placental polyp
C. Choriocarcinoma
D. Papyraceous fetus
E. Lithopedion
109. A 4 y.o. boy has had recently seri-
ous viral hepatitis. Now there are such
clinical presentations as vomiting, loss
of consciousness, convulsions. Blood
analysis revealed hyperammoniemia. Di-
sturbunce of which biochemical process
caused such pathological condition of the
patient?
12
A. Disturbed neutralization of ammonia in
liver
B. Disturbed neutralization of biogenic
amines
C. Increased putrefaction of proteins in
bowels
D. Activation of aminoacid decarboxylati-
on
E. Inhibition of transamination enzyms
110. Examination of a patient revealed
hyperkaliemia and hyponatremia. Low
secretion of which hormone may cause
such changes?
A. Aldosteron
B. Vasopressin
C. Cortisol
D. Parathormone
E. Natriuretic
111. In course of indirect histogenesis
of tubular bone tissue a plate is formed
between epiphyseal and diaphyseal ossi-
fication centres that provides further
lengthwise growth of bones. What
structure is it?
A. Metaphyseal plate
B. Osseous cuff
C. Osseous plate
D. Osteon
E. Layer of interior general plates
112. A 40 y.o. woman was admitted to
the infectious diseases department wi-
th high body temperature. Objectively:
evident meningeal symptoms. A spinal
cord punction was made. What anatomic
formation was punctured?
A. Spatium subarachnoideum
B. Spatium subdurale
C. Spatium epidurale
D. Cavum trigeminale
E. Cisterna cerebellomedullaris posterior
113. After resection of the middle third of
femoral artery obliterated by a thromb
the lower extremity is supplied with blood
due to the surgical bypass. Name an artery
that plays the main role in reestablishment
of blood flow:
A. Deep femoral artery
B. Superficial circumflex artery of hip bone
C. Descending genicular artery
D. Superficial epigastric artery
E. Deep external pudendal artery
114. A patient’s knee joint doesn’t extend,
there is no knee-jerk reflex, skin sensi-
tivity of the anterior femoral surface
 Krok 1 Medicine 2007
is disturbed. What nerve structures are
damaged?
A. Femoral nerve
B. Superior gluteal nerve
C. Big fibular nerve
D. Obturator nerve
E. Inferior gluteal nerve
115. An electron micrograph of a kidney
fragment presents an afferent arteriole.
Under its endothelium some big cells can
be seen that contain secretory granules.
What type of cells is it?
A. Juxtaglomerular
B. Mesangeal
C. Smooth muscle cells
D. Juxtavascular
E. Interstitial
116. For the purpose of retrtospective di-
agnostics of recent bacterial dysentery it
was decided to perform serological exami-
nation of blood serum in order to determi-
ne antibody titer towards Shiga bacilli.
What of the following reactions should
be applied?
A. Passive hemagglutination
B. Bordet-Gengou test
C. Precipitation
D. Hemolysis
E. Bacteriolysis
117. Examination of a 43 y.o. anephric
patient revealed anemia symptoms. What
is the cause of these symptoms?
A. Reduced synthesis of erythropoietins
B. Enhanced destruction of erythrocytes
C. Iron deficit
D. Vitamin B12 deficit
E. Folic acid deficit
118. A 50 y.o. patient was admitted to
the hospital with complaints about pain
behind his breastbone, asphyxia during
physical activity. Angiography revealed
pathological changes in the posteri-
or interventricular branch of the right
coronary artery. What heart parts are
affected?
A. Posterior wall of the right and left
ventricles
B. Left atrium
C. Anterior wall of the right and left
ventricles
D. Right atrium
E. Right atrioventricular valve
119. 48 hours after performing tuberculin
13
test (Mantoux test) to a child a 10 mm
papule appeared on the spot of tuberculin
introduction. What hypersensitivity
mechanism underlies these changes?
A. Cellular cytotoxicity
B. Anaphylaxis
C. Antibody-dependent cytotoxicity
D. Immune complex cytotoxicity
E. Granulomatosis
120. Examination of a newborn boy’s
genitals revealed a cleft of urethra that
opens on the inferior surface of his penis.
What developmental anomaly is it?
A. Hypospadia
B. Hermaphroditism
C. Epispadia
D. Monorchism
E. Cryptorchism
121. A patient has a disturbed absorbtion
of fat hydrolysates. It might have been
caused by a deficit in the small intestine
cavity:
A. Of bile acids
B. Of bile pigments
C. Of lipolytic enzymes
D. Of sodium ions
E. Of liposoluble vitamins
122. Inhabitants of territories with cold
climate have high content of an adapti-
ve thermoregulatory hormone. What
hormone is meant?
A. Thyroxin
B. Insulin
C. Glucagon
D. Somatotropin
E. Cortisol
123. Violation of safety rules resulted
in calomel intoxication. Two days later
the daily diuresis was 620 ml. A pati-
ent experienced headache, vomiting,
convulsions, dyspnea, moist rales in lungs.
What pathology is it?
A. Acute renal insufficiency
B. Chronic renal insufficiency
C. Uraemic coma
D. Glomerulonephritis
E. Pyelonephritis
124. A newborn child with pylorostenosis
has often repeating vomiting accompani-
ed by apathy, weakness, hypertonicity,
sometimes convulsions. What disorder
form of acid-base balance is it?
 Krok 1 Medicine 2007 14

A. Nongaseous alkalosis of this opening. What anomaly of external

B. Gaseous alkalosis genitals development is the case?
C. Gaseous acidosis
D. Metabolic acidosis A. Epispadia
E. Excretory acidosis B. Phimosis
C. Hermaphroditism
125. Glutamate decarboxylation results D. Paraphimosis
in formation of inhibitory transmitter in E. Hypospadia
CNS. Name it:
131. A patient complains of pain in the
A. GABA area of his liver. Duodenal intubation
B. Glutathione revealed yellowish, oval, narrowed at the
C. Histamine poles eggs with an operculum at the end.
D. Serotonin Size of these eggs is the smallest among all
E. Asparagine helminth eggs. What is the most probable
diagnosis?
126. In course of histidine catabolism a bi-
ogenic amin is formed that has powerful A. Opisthorchosis
vasodilatating effect. Name it: B. Teniasis
C. Beef tapeworm infection
A. Histamine D. Echinococcosis
B. Serotonin E. Diphyllobothriasis
C. Dioxyphenylalanine
D. Noradrenalin 132. Colonoscopy of a patient ill wi-
E. Dopamine th dysentery revealed that mucous
membrane of his large intestine is
127. Utilization of arachidonic acid hyperemic, edematic, its surface was
via cyclooxigenase pathway results in covered with grey-and-green coats. Name
formation of some bioactive substances. the morphological form of dysenteric
Name them: collitis:
A. Prostaglandins A. Fibrinous
B. Thyroxine B. Catarrhal
C. Biogenic amins C. Ulcerous
D. Somatomedins D. Purulent
E. Insulin-like growth factors E. Necrotic
128. As a result of damage to certain 133. 24 hours after appendectomy
structures of brainstem an animal lost ori- blood of a patient presents neutrophi-
entation reflexes. What structures were lic leukocytosis with regenerative shift.
damaged? What is the most probable mechanism of
A. Quadritubercular bodies leukocytosis development?
B. Medial nuclei of reticular formation A. Amplification of leukopoiesis
C. Red nuclei B. Redistribution of leukocytes in the
D. Vestibular nuclei organism
E. Black substance C. Decelerated leukocyte destruction
129. Osmotic pressure of a man’s blood D. Deceleratied emigration of leukocytes
to the tissues
plasma is 350 mosmole/l (standard E. Amplification of leukopoiesis and
pressure is 300 mosmole/l). First of all it decelerated emigration of leukocytes to
will result in high secretion of the followi- the tissues
ng hormone:
134. Arterial pressure of a surgeon who
A. Vasopressin performed a long operation rised up to
B. Aldosteron 140/110 mm Hg. What changes of humoral
C. Cortisol regulation could have caused the rise of
D. Adrenocorticotropin arterial pressure in this case?
E. Natriuretic
130. A young man consulted a doctor
about disturbed urination. Examinati-
on of his external genitals revealed that
urethra is split on top and urine runs out
 Krok 1 Medicine 2007
A. Activation of sympathoadrenal system
B. Activation of formation and excretion
of aldosterone
C. Activation of renin angiotensive system
D. Activation of kallikrein kinin system
E. Inhibition of sympathoadrenal system
135. A hypertensive glucose solution was
introduced to a patient. It will intensify
water movement:
A. From the cells to the intercellular liquid
B. From the intercellular liquid to the
capillaries
C. From the intercellular liquid to the cells
D. From the capillaries to the intercellular
liquid
E. There will be no changes of water
movement
136. A 36 y.o. man has a craniocerebral
trauma. Objectively: diminished breath
sounds, thready pulse, no reflexes. What
way of pyracetam introduction will be the
most apropriate in this case?
A. Intravenous
B. Rectal
C. Subcutaneous
D. Peroral
E. Inhalation
137. A child complains of general
weakness, loss of appetite, a troubled
sleep, itching in the perianal area. The
provisional diagnosis is enterobiasis.
In order to specify this diagnosis it is
necessary to perform:
A. Scraping from perianal folds
B. Roentgenoscopy
C. Biopsy of muscle tissue
D. Immune diagnostics
E. Duodenal contents analysis
138. A patient was ill with burn disease
that was complicated by DIC syndrome.
What stage of DIC syndrome can be
suspected if it is known that the patient’s
blood coagulates in less than 3 minutes?
A. Hypercoagulation
B. Transition phase
C. Hypocoagulation
D. Fibrinolysis
E. Terminal
139. In course of practical training
students studied a stained blood smear
of a mouse with bacteria phagocyted by
leukocytes. What cell organella completes
digestion of these bacteria?
15
A. Lisosomes
B. Mytochondrions
C. Granular endoplasmic reticulum
D. Golgi apparatus
E. Ribosomes
140. A 55 y.o. woman consulted a doctor
about having continuous cyclic uterine
hemorrhages for a year, weakness, dizzi-
ness. Examination revealed skin pallor.
Hemogram: Hb- 70 g/l, erythrocytes -
3, 2 · 1012 /l, color index - 0,6, leukocytes
- 6, 0 · 109 /l, reticulocytes - 1%; erythrocyte
hypochromia. What anemia is it?
A. Chronic posthemorrhagic anemia
B. Hemolytic anemia
C. Aplastic anemia
D. B12 -folate-deficiency anemia
E. Iron-deficiency anemia
141. According to audiometry data a pati-
ent has a disturbed perception of medium-
frequency sounds. It might have been
caused by a damage of:
A. Middle part of helix
B. Cochlear nuclei
C. Spiral ganglion
D. Quadritubercular structure
E. Lateral geniculate bodies
142. A patient diagnosed with carcinoid
of bowels was admitted to the hospi-
tal. Analysis revealed high production of
serotonin. It is known that this substance
is formed of tryptophane aminooacid.
What biochemical mechanism underlies
this process?
A. Decarboxylation
B. Desamination
C. Microsomal oxydation
D. Transamination
E. Formation of paired compounds
143. A 23 y.o. patient complains of
weakness, temperature rise up to 38 −
400 C. Objectively: liver and spleen
are enlarged. Hemogram: Hb- 100 g/l,
erythrocytes - 2, 9 · 1012 /l, leukocytes -
4, 4 · 109 /l, thrombocytes - 48 · 109 /l,
segmentonuclear neutrophils - 17%,
lymphocytes - 15%, blast cells - 68%.
All cytochemical reactions are negative.
Make a hematological conclusion:
A. Undifferentiated leukosis
B. Chronic myeloleukosis
C. Acute myeloblastic leukosis
D. Acute lymphoblastic leukosis
E. Acute erythromyelosis
 Krok 1 Medicine 2007 16

144. A patient ill with bronchial asthma di- A. Transamination and decarboxylation of
dn’t inform his doctor that he had attacks aminoacids
of stenocardia. Doctor administered him B. Oxidative decarboxylation of ketonic
a medication, which taking resulted in acids
less frequent attacks of bronchial asthma, C. Desamination of purine nucleotide
but stenocardia attacks became more D. Synthesis of purine and pyrimidine
frequent. What medication was admini- bases
stered? E. Protein synthesis
A. Isadrin 149. In course of an operation surgeon
B. Salbutamol removed a part of a lung that was venti-
C. Aminophylline lated by a tertiary bronchus accompani-
D. Cromolyn sodium ed by branches of pulmonary artery and
E. Phenotherol other vessels. What part of a lung was
removed?
145. A patient who has been sufferi-
ng from cardiac insufficiency for several A. Bronchopulmonary segment
months has been taking digoxin on B. Middle lobe
an outpatient basis. At a certain stage C. Inferior lobe
of treatment there appeared symptoms D. Superior lobe
of drug overdose. What phenomenon E. Pulmonary lobule
underlies the development of this compli-
cation? 150. A patient with clinical presentati-
ons of immunodeficiency went through
A. Material cumulation immunological examinations. They
B. Habituation revealed significant loss of cells that form
C. Sensibilization rosettes with erythrocytes of a ram. What
D. Functional cumulation conclusion can be made according to the
E. Tachyphylaxis analysis data?
146. A patient who has been treated A. Decrease of T-lymphocytes rate
with diazepam on account of neurosis B. Decrease of B-lymphocytes rate
complains of toothache. Doctor admi- C. Decrease of natural killer cell rate
nistered him an analgetic, but its dose D. Decrease of complement system rate
was lower than average therapeutic dose. E. Insufficiency of effector cells of humoral
What phenomenon did the doctor take immunity
into account while prescribing the patient
an underdose? 151. A woman with (B), Rh− blood
group born a child with (A) blood
A. Potentiation group. The child is diagnosed with
B. Summation hemolytic disease of newborn as a result
C. Cumulation of rhesus incompatibility. What blood
D. Drug dependence group is the child’s father likely to have?
E. Tolerance
A. (A), Rh+
147. A child’s blood presents high content B. I (0), Rh+
of galactose, glucose concentration is low. C. III (B), Rh+
There are such presentations as cataract, D. I (0), Rh−
mental deficiency, adipose degeneration E. II (A), Rh−
of liver. What disease is it?
152. A 45 y.o. woman suffers from
A. Galactosemia Cushing’s syndrome - steroid diabetes.
B. Diabetes mellitus Biochemical examination revealed:
C. Lactosemia hyperglycemia, hypochloremia. Which of
D. Steroid diabetes the under-mentioned processes is the first
E. Fructosemia to be activated?
148. According to clinical indications A. Gluconeogenesis
a patient was administered pyridoxal B. Glycogenolysis
phosphate. What processes is this medi- C. Glucose reabsorption
cation intended to correct? D. Glucose transport to the cell
E. Glycolysis
 Krok 1 Medicine 2007
153. Histological specimen presents a
vessel the wall of which consists of
endothelium, basal membrane and loose
connective tissue. What type of vessel is
it?
A. Vein of non-muscular type
B. Artery
C. Vein of muscular type
D. Hemocapillary
E. Lymphocapillary
154. Autopsy of a 48 y.o. man revealed a
round formation 5 cm in diameter with
clear-cut outlines in the region of the 1st
segment of his right lung. This formation
was encircled with a thin layer of connecti-
ve tissue full of white brittle masses. Make
a diagnosis of the secondary tuberculosis
form:
A. Tuberculoma
B. Caseous pneumonia
C. Acute cavernous tuberculosis
D. Acute focal tuberculosis
E. Fibrous cavernous tuberculosis
155. A patient who suffers from
acute myocarditis has clinical signs
of cardiogenic shock. What of the
under-mentioned pathogenetic mechani-
sms plays the main part in shock
development?
A. Disturbance of pumping ability of heart
B. Depositing of blood in organs
C. Reduction of diastolic flow to the heart
D. Decrease of vascular tone
E. Increase of peripheral vascular resi-
stance
156. On the 6th day of treatment a patient
with acute renal insufficiency developed
polyuria. Diuresis intensification at the
beginning of polyuria stage of acute renal
insufficiency is caused by:
A. Renewal of filtration in nephrons
B. Volume expansion of circulating blood
C. Growth of natriuretic factor
D. Reduction of aldosteron content in
plasma
E. Reduction of vasopressin content in
plasma
157. Long-term starvation cure of a pati-
ent resulted in diminished ratio of albumi-
nes and globulines in plasma. What of the
following will be result of these changes?
17
A. Increase of ESR
B. Decrease of ESR
C. Increase of hematocrit
D. Decrease of hematocrit
E. Hypercoagulation
158. An experimental animal was fi-
rst sensibilized whereupon an antigen
dose was introduced subcutaneously. This
injection resulted in the development of
a fibrinous inflammation with alteration
of vessel walls, basal substance and fi-
brous structures of connective tissue in
form of mucoid and fibrinoid swelling and
necrosis. What immunological reaction
took place?
A. Immediate hypersensitivity
B. Delayed-type hypersensitivity
C. Reaction of transplantation immunity
D. Normergic reaction
E. Granulomatosis
159. A patient suffers from vision impai-
rment - hemeralopy (night blindness).
What vitamin preparation should be
administered the patient in order to
restore his vision?
A. Retinol acetate
B. Vicasol
C. Pyridoxine
D. Thiamine chloride
E. Tocopherol acetate
160. A 1 y.o. child with symptoms of
muscle affection was admitted to the
hospital. Examination revealed carnitine
deficit in muscles. Biochemical base of this
pathology is disturbed process of:
A. Transporting of fatty acids to mi-
tochondrions
B. Regulation of Ca2+ rate in mitochondri-
ons
C. Substrate phosphorylation
D. Lactic acid utilization
E. Actin and myosin synthesis
161. A patient suffers from severe
postoperative pseudomonadous infection.
What of the following antibiotics should
be administered in this case?
A. Amicacin sulfate
B. Benzylpenicillin
C. Cephazolin
D. Erythromycin
E. Doxycycline
162. A 9 m.o. child has delayed dentition,
it is also out of order. Upper jaw confi-
guration is horizontal ("high"palate); mi-
 Krok 1 Medicine 2007
croscopically - irregular mineralization of
tooth enamel, wrinkled enamel prisms,
some of them are vacuolized. Predentin
zone is extended; there are solitary denti-
cles. What disease is it?
A. Early rickets
B. Late rickets
C. Osteomalacia
D. Gout
E. Hypervitaminosis D
163. Examination of a patient revealed an
abscess of pterygopalatine fossa. Where
can the infection spread to unless the di-
sease is managed in time?
A. To the orbit
B. To the interpterygoid space
C. To the frontal sinus
D. To the subgaleal temporal space
E. To the tympanic cavity
164. Microscopical renal examination of
a 36 y.o. woman who died from renal
insufficiency revealed in the glomerules
proliferation of capsule nephrothelium
as well as of podocytes and phagocytes
accompanied by formation of "crescents",
capillary loop necrosis, fibrinous thrombs
in their lumens; sclerosis and hyalinosis
of glomerules, atrophy of tubules and fi-
brosis of renal stroma. What is the most
probable diagnosis?
A. Subacute glomerulonephritis
B. Acute glomerulonephritis
C. Chronic glomerulonephritis
D. Focal segmentary sclerosis
E. Membranous nephropathy
165. A forensic medical expert exami-
nes the body of a 58 y.o. man who
had been consuming large amounts of
alcochol for a long time and died at home.
Microscopicaly: the right lung is dense
and enlarged, its incision revealed that
the tissue is greyish and homogenous,
pleura is covered with greyish layers. Mi-
croscopically - alveolar cavities contain
fibrin, hemolyzed erythrocytes. Make a
diagnosis:
A. Croupous pneumonia
B. Focal pneumonia
C. Interstitial pneumonia
D. Primary pulmonary tuberculosis
E. Caseous pneumonia
166. Two days after consumption of
smoked pork a patient got face and eye-
lid edemata, gastrointestinal disturbances,
abrupt temperature rise, muscle pain.
18
Blood analysis showed full-blown eosi-
nophilia. What helminth could the patient
be infected with?
A. Trichina
B. Pinworm
C. Ascarid
D. Whipworm
E. Hookworm
167. After a tooth extraction a patient felt
persistent pain behind his breast bone.
After sublingual intake of an antianginal
drug the pain behind the breast bone di-
sappeared, but the patient complained of
headache and dizziness. What drug are
these properties typical for?
A. Nitroglycerin
B. Propranolol
C. Metoprolol
D. Validol
E. Verapamil
168. A patient with fracture of his lower
jaw was admitted to the maxillofaci-
al department. It was decided to fix
his bones surgically under anaesthetic.
After intravenous introduction of muscle
relaxant there arose short fibrillar
contractions of the patient’s facial
muscles. What muscle relaxant was appli-
ed?
A. Dithylinum
B. Tubocurarin chloride
C. Pipecuronium bromide
D. Diazepam
E. Melictine
169. Autopsy of a 56 y.o. man revealed in
the right temporal part of brain a big focus
of softened grey matter that was semi-
liquid and light grey. Arteries of cerebral
tela contain multiple whitish-yellow thi-
ckenings of intima that abruptly narrow
the lumen. What is your diagnosis?
A. Ischemic stroke
B. Brain abscess
C. Hemorrhage
D. Hemorrhagic infarction
E. Brain edema
170. Vitamin A deficit results in the
impairment of twilight vision. Name the
cells that have the above-mentioned
photoreceptor function:
 Krok 1 Medicine 2007 19

A. Rod receptor cell cells of male sexual glands produce this

B. Horizontal neurocytes hormone?
C. Cone receptor cells
D. Bipolar neurons A. Leidig cells
E. Ganglion neurocytes B. Sustentocytes
C. Sertoli’s cells
171. Neurological examination of a 65 y.o. D. Supporting cells
patient revealed a haemorrhage within E. Spermatozoa
the superior temporal gyrus. In the blood
supply area of which artery is it? 176. An isolated cell of human heart
automatically generates excitation
A. Middle cerebral artery impulses with frequency 60 times pro mi-
B. Anterior cerebral artery nute. What heart structure was this cell
C. Posterior cerebral artery obtained from?
D. Anterior communicating artery
E. Basilar artery A. Sinoatrial node
B. Atrium
172. A 70 y.o. man has cut an abscess C. Ventricle
off in the area of mammiform process D. Atrioventricular node
during shaving. Two days later he was E. His’ bundle
admitted to the hospital with inflammati-
on of arachnoid membranes. How did 177. Examination of a patient revealed
the infection penetrate into the cavity of a strong, balanced, inert type of higher
skull? nervous activity according to Pavlov. What
temperament type does the patient have
A. V.emissaria mastoidea (according to Hippocrates classification)?
B. V.v.labyrinthi
C. V.v.tympanicae A. Phlegmatic
D. V.f acialis B. Sanguine
E. V.v.auriculares C. Choleric
D. Melancholic
173. A 22 y.o. woman has enlarged lymph E. -
nodes. Histologically: a lymph node
contains lymphocytes, histiocytes, reti- 178. A patient has a haemorrhage into
cular cells, small and big Hodgkin’s cells, the posterior central gyrus. What type of
multinucleated Sternberg cells, isolated sensitivity on the opposite side will be di-
foci of caseous necrosis. What disease are sturbed?
these changes typical for?
A. Skin and proprioceptive
A. Lymphogranulomatosis B. Visual
B. Lymphosarcoma C. Auditory
C. Chronic leukosis D. Olfactory
D. Acute leukosis E. Auditory and visual
E. Lung cancer metastasis
179. Analysis of a punction biopsy materi-
174. A lymph node punctate of a pati- al of liver revealed hepatocyte dystrophy
ent with suspected protozoal disease was with necroses as well as sclerosis with di-
examined. Examination of the stained sorder of beam and lobulous structure,
specimen (Romanovsky’s stain) revealed with formation of pseudolobules and
some crescent bodies with pointed end, regenerative nodes. What is the most
blue cytoplasm and red nucleus. What probable diagnosis:
protozoan were revealed in the smears?
A. Liver cirrhosis
A. Toxoplasms B. Chronic hepatosis
B. Malarial plasmodiums C. Chronic hepatitis
C. Dermotropic leishmania D. Progressive massive liver necrosis
D. Viscerotropic leishmania E. Acute hepatitis
E. Trypanosomes
180. Examination of a 60 y.o. patient
175. During pubescence the cells of revealed hyperglycemia and glucosuria.
male sexual glands begin to produce A doctor administered him a medication
male sex hormon testosterone that calls for internal use. What medication is it?
forth secondary sexual characters. What
 Krok 1 Medicine 2007 20

A. Glibenclamid of basophilic cytoplasma that resemble

B. Furosemide of cells of basal epidermal layer. What
C. Oxytocin tumour is it?
D. Pancreatine
E. Corglycon A. Basalioma
B. Epidermal cancer
181. A patient who had been working hard C. Hydradenoma
under conditions of elevated temperature D. Trichoepithelioma
of the environment, has now a changed E. Syringoadenoma
quantity of blood plasma proteins. What
penomenon is the case? 186. A patient has pain, edema and
reddening of his skin in the anterosuperi-
A. Relative hyperproteinemia or area of his thigh and his foot’s thumb.
B. Absolute hyperproteinemia What lymph nodes of his lower extremity
C. Absolute hypoproteinemia responded to the inflammatory process?
D. Disproteinemia
E. Paraproteinemia A. Superficial inguinal
B. Deep inguinal
182. An experimental rat with extremity C. Internal longitudinal
paralysis has no tendon and cutaneous D. Superficial longitudinal
reflexes, muscle tone is decreased, but E. General longitudinal
muscles of the affected extremity mai-
ntain their ability to react with excitation 187. A laboratory received a material from
to the direct action of continious current. a patient’s wound. Ppreliminary diagnosis
What type of paralysis is it? is gaseous gangrene. What microbiologi-
cal method should be applied to determi-
A. Flaccid peripheral ne species of causative agent?
B. Flaccid central
C. Spastic peripheral A. Bacteriological
D. Spastic central B. Allergic
E. Extrapyramidal C. Bacterioscopic
D. Serological
183. A liquidator of a breakdown at a E. RIA
nuclear power plant who was irradiated
complained about vomiting that occurs all 188. Examination of cell culture got
of a sudden. What medication should be from a patient with lysosomal pathology
prescribed? revealed accumulation of great quantity
of lipids in the lysosomes. What of the
A. Metoclopramide following diseases is this disturbance typi-
B. Reserpine cal for?
C. Atropine
D. Aeron A. Tay-Sachs disease
E. De-Nol B. Gout
C. Phenylketonuria
184. Urine examination of a patient with D. Wilson disease
acute cystitis revealed leukocytes and a E. Galactosemia
lot of gram-negative bacilli. Inoculation
resulted in growth of colonies of mucous 189. A patient got a craniocerebral
nature that formed green soluble pigment. trauma that resulted in right-side
What microorganism is the most probable convergent strabismus. Damage of whi-
cause of the disease? ch craniocerebral nerve caused such
consequences?
A. P seudomonas aeruginosa
B. Escherihia coli A. n.abducens
C. Klebsiella pneumoniae B. n.f acialis
D. P roteus mirabilis C. n.trigeminus
E. Salmonella enteritidis D. n.trochlearis
E. n.aculomotorius
185. A 45 y.o. patient consulted a doctor
about plaque-shaped formation on his 190. In case of a penetrating wound of
neck. Histological examination of biopsy the anterior abdominal wall the wound
skin material revealed tumourous cells tract went above the lesser curvature of
of round and oval form with thin ring stomach. What peritoneum formation is
 Krok 1 Medicine 2007
most likely to be injured?
A. Ligamentum hepatogastricum
B. Ligamentum gastrocolicum
C. Ligamentum hepatoduoduodenale
D. Ligamentum hepatorenale
E. Ligamentum triangulare sinistrum
191. A rabbit’s nerve that innervates the
right ear was cut and its right superior
cervical ganglion was removed. Immedi-
ately after operation the temperature of
ear skin was measured. It was revealed
that the temperature of the rabbit’s ear
skin on the side of denervation was
by 1, 50 C higher than on the opposite
intact side. What of the following is the
most probable explanation of the above-
mentioned effects?
A. Arterial neuroparalytic hyperemia
B. Arterial neurotopical hyperemia
C. Atrerial hyperemia induced by
metabolic factors
D. Reactive arterial hyperemia
E. Physiological arterial hyperemia
192. A 63 y.o. man fell ill with acute
tracheitis and bronchitis accompanied by
bronchial pneumonia. On the 10th day
the patient died from cardiopulmonary
insufficiency. Autopsy revealed fibrinous
hemorrhagic laryngotracheobronchi-
tis; lungs were enlarged, their incision
revealed the "coal-miner’s"effect caused
by interlacing of sections of bronchi-
al pneumonia, hemorrhages into the
pulmonary parenchyma, acute abscesses
and atelectases. Internal organs have di-
scirculatory and dystrophic changes. What
is the most probable diagnosis?
A. Influenza, severe form
B. Moderately severe influenza
C. Parainfluenza
D. Respiratory syncytial infection
E. Adenoviral infection
193. Autopsy of a man who died from
influenza revealed that his heart was sli-
ghtly enlarged, pastous, myocardium was
dull and had specks. Microscopical exami-
nation of myocardium revealed signs of
parenchymatous adipose and hydropic
dystrophy; stroma was edematic with poor
macrophagal and lymphocytic infiltrati-
on, vessels were plethoric; perivascular
analysis revealed petechial hemorrhages.
What type of myocarditis was developed
in this case?
21
A. Serous diffuse
B. Interstitial proliferative
C. Serous focal
D. Purulent
E. Granulomatous
194. A patient with chronic cardiac insuffi-
ciency has been treated with cardiotonic
drugs and a thiazide diuretic, but in spi-
te of it there are still edemata and risk
of ascites. What medication should be
prescribed to amplify diuretic effect of the
applied drugs?
A. Spironolactone
B. Furosemide
C. Amyloride
D. Clopamide
E. Manitole
195. A patient ill with collagenesis has
been taking prednisolone for a long ti-
me. Hypokaliemia development caused
spastic pain of skeletal muscles. What
medication should be used in order to
correct potassium exchange?
A. Panangin
B. Dithylinum
C. Diazepam
D. Noshpa
E. Thyrocalcitonin
196. A boy is 7 y.o. Objectively: against
the background of hyperemic skin there is
knobby bright-pink rash on his forehead,
neck, at the bottom of abdomen, in
the popliteal spaces; nasolabial triangle
is pale. Examination of oropharyngeal
surface revealed localized bright-red
hyperemia; tonsils are swollen, soft,
lacunas contain pus, tongue is crimson.
Cervical lymph nodes are enlarged, dense
and painful. What is the most probable di-
agnosis?
A. Scarlet fever
B. Rubella
C. Whooping cough
D. Diphtheria
E. Infectious mononucleosis
197. A patient complains of dryness of
head skin, itching, fragility and loss of hair.
After examination he was diagnosed wi-
th seborrhea. Disturbed activity of which
cells caused this condition?
 Krok 1 Medicine 2007
A. Cells of sebaceous glands
B. Cells of sudoriferous glands
C. Epithelial cells
D. Adipocytes
E. Melanocytes
198. In the surgical department of a
hospital there was an outbreak of hospi-
tal infection that showed itself in often
postoperative wound abscesses. Bacteri-
ological examination of pus revealed
aurococcus. What examination shall be
conducted to find out the source of this
causative agent among the department
personnel?
A. Phagotyping
B. Microscopical examination
C. Serological identification
D. Estimation of antibiotic susceptibility
E. Biochemical identification
199. Short-term physical activity resulted
22
in reflex amplification of heart rate and
raise of systemic arterial pressure. What
receptors activation was the main cause of
pressor reflex realization?
A. Proprioreceptors of active muscles
B. Vascular chemoreceptors
C. Vascular volume receptors
D. Vascular baroceptors
E. Hypothalamus thermoreceptors
200. In course of an experiment a skeletal
muscle is being stimulated by a series of
electric impulses. What type of muscle
contraction will arise, if every subsequent
impulse comes in the period of relaxation
of single muscle contraction?
A. Partial tetanus
B. Holotetanus
C. A series of single contractions
D. Muscle contructure
E. Asynchronous tetanus
 Krok 1 Medicine 2008
1. After consumption of rich food
a patient has nausea and heartburn,
steatorrhea. This condition might be
caused by:
A. Bile acid deficiency
B. Increased lipase secretion
C. Disturbed tripsin synthesis
D. Amylase deficiency
E. Disturbed phospholipase synthesis
2. An infant has apparent diarrhea resulti-
ng from improper feeding. One of the
main diarrhea effects is plentiful excreti-
on of sodium bicarbonate. What form of
acid-base balance disorder is the case?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. No disorders of acid-base balance will
be observed
3. A 3 year old child with fever was
given aspirin. It resulted in intensifi-
ed erythrocyte haemolysis. Hemolytic
anemia might have been caused by
congenital insufficiency of the following
enzyme:
A. Glucose 6-phosphate dehydrogenase
B. Glucose 6-phosphatase
C. Glycogen phosphorylase
D. Glycerol phosphate dehydrogenase
E. γ-glutamiltransferase
4. A patient is ill with diabetes melli-
tus accompanied by hyperglycemia on
an empty stomach (7,2 millimole/l). The
hyperglycemia rate can be retrospecti-
vely estimated (over the last 4-8 weeks
before the examination) on the ground
of the rate of the following blood plasma
protein:
A. Glycated hemoglobin
B. Albumin
C. Fibrinogen
D. C-reactive protein
E. Ceruloplasmin
5. In course of laparotomy a surgeon
revealed gangrenous lesion of descendi-
ng colon. It was caused by thrombosis of
the following artery:
A. Sinister colic
B. Median colic
C. Dexter colic
D. Ileocolic
E. Superior mesenteric artery
1
6. A 37 year old patient suffering from
obliterating vascular endarteritis of lower
limbs takes daily 60 microgram/kilogram
of phenylin. Because of presentations
of convulsive disorder (craniocerebral
trauma in anamnesis) he was prescri-
bed phenobarbital. Withholding this drug
caused nasal hemorhage. What is this
complication connected with?
A. Induction of enzymes of microsomal
oxidation in liver caused by phenobarbital
B. Aliphatic hydroxylation of phenobarbi-
tal
C. Conjugation of phenylin with glucuronic
acid
D. Oxidative deamination of phenylin
E. Inhibition of microsomal oxidation in
liver caused by phenobarbital
7. A 60 year old patient has impaired
perception of high-frequency sounds.
These changes were caused by damage of
the following auditory analyzer structures:
A. Main cochlea membrane near the oval
window
B. Main cochlea membrane near the
helicotrema
C. Eustachian tube
D. Middle ear muscles
E. Tympanic membrane
8. Researchers isolated 5 isoenzymic
forms of lactate dehydrogenase from the
human blood serum and studied their
properties. What property indicates that
the isoenzymic forms were isolated from
the same enzyme?
A. Catalyzation of the same reaction
B. The same molecular weight
C. The same physicochemical properties
D. Tissue localization
E. The same electrophoretic mobility
9. It was proved that a molecule of
immature mRNA (precursor mRNA)
contained more triplets than amino aci-
ds found in the synthesized protein.
The reason for that is that translation is
normally preceded by:
A. Processing
B. Initiation
C. Reparation
D. Mutation
E. Replication
10. A patient has low rate of magnesium
ions that are necessary for affixion of ri-
bosomes to the endoplasmic reticulum.
It is known that it causes disturbance
 Krok 1 Medicine 2008
of protein biosynthesis. At what stage is
protein biosynthesis impaired?
A. Translation
B. Transcription
C. Replication
D. Amino acid activation
E. Termination
11. A student takes notes of a lecture.
Quality of his notes became significantly
worse when his neighbours began talking.
What type of conditional reflex inhibition
was the cause of it?
A. External
B. Protective
C. Extinctive
D. Differentiated
E. Delayed
12. A patient ill with neurodermatitis has
been taking prednisolone for a long time.
Examination revealed high rate of sugar
in his blood. This complication is caused
by the drug influence upon the following
link of carbohydrate metabolism:
A. Gluconeogenesis activation
B. Glycogenogenesis activation
C. Intensification of glucose absorption in
the bowels
D. Inhibition of glycogen synthesis
E. Activation of insulin decomposition
13. Labelled amino acids alanine and
tryptophane were injected to a mouse
in order to study localization of protein
synthesis in its cells. The labelled ami-
no acids will be accumulated near the
following organellas:
A. Ribosomes
B. Smooth endoplasmic reticulum
C. Cell centre
D. Lysosomes
E. Golgi apparatus
14. A patient with frequent attacks of
stenocardia was prescribed sustak-forte
to be taken one tablet twice a day. At first
the effect was positive but on the second
day stenocardia attacks resumed. What
can explain inefficiency of the prescribed
drug?
A. Tachyphylaxis
B. Cumulation
C. Sensibilization
D. Idiosyncrasy
E. Dependence
15. Inflammation of the tympanic cavity
2
(purulent otitis media) was complicated
by inflammation of mammillary process
sockets. What wall of tympanic cavity
did the pus penetrate into the sockets
through?
A. Posterior
B. Anterior
C. Medial
D. Lateral
E. Superior
16. In order to speed up healing of a
wound of oral mucosa a patient was
prescribed a drug that is a thermostable
protein occuring in tears, saliva, mother’s
milk as well as in a new-laid hen’s egg. It
is known that this protein is a factor of
natural resistance of an organism. What is
it called?
A. Lysozyme
B. Complement
C. Interferon
D. Interleukin
E. Imanine
17. An aged man had raise of arterial
pressure under a stress. It was caused by
activation of:
A. Sympathoadrenal system
B. Parasympathetic nucleus of vagus
C. Functions of thyroid gland
D. Functions of adrenal cortex
E. Hypophysis function
18. A 20 year old patient complains of
general weakness, dizziness, quick fati-
gability. Blood analysis results: Hb- 80
g/l. Microscopical examination results:
erythrocytes are of modified form. This
condition might be caused by:
A. Sickle-cell anemia
B. Hepatocellular jaundice
C. Acute intermittent porphyria
D. Obturative jaundice
E. Addison’s disease
19. Blood minute volume of a 30 year old
woman at rest is 5 l/m. What blood volume
is pumped through the pulmonary vessels
per minute?
A. 5 l
B. 3,75 l
C. 2,5 l
D. 2,0 l
E. 1,5 l
20. As a result of long-term starvation
the glomerular filtration of a man was
 Krok 1 Medicine 2008
accelerated by 20%. The most probable
cause of filtration changes under such
conditions is:
A. Fall of oncotic pressure of blood plasma
B. Rise of systemic arterial pressure
C. Increased permeability of renal filter
D. Growth of filtration coefficient
E. Increase of renal plasma flow
21. A patient has yellow skin colour, dark
urine, dark-yellow feces. What substance
will have strengthened concentration in
the blood serum?
A. Unconjugated bilirubin
B. Conjugated bilirubin
C. Mesobilirubin
D. Verdoglobin
E. Biliverdin
22. A patient consulted a doctor about
symmetric dermatitis of open skin areas.
It was found out that the patient lived
mostly on cereals and ate too little meat,
milk and eggs. What vitamin deficiency is
the most evident?
A. Nicotinamide
B. Calciferol
C. Folic acid
D. Biotin
E. Tocopherol
23. A 46 year old patient applied to a
doctor complaining about joint pain that
becomes stronger the day before weather
changes. Blood examination revealed
strengthened concentration of uric acid.
The most probable cause of the disease
is the intensified disintegration of the
following substance:
A. Adenosine monophosphate
B. Cytidine monophosphate
C. Uridine triphosphate
D. Uridine monophosphate
E. Thymidine monophosphate
24. A 38 year old patient suffers from
rheumatism in its active phase. What
laboratory characteristic of blood serum
is of diagnostic importance in case of this
pathology?
A. C-reactive protein
B. Uric acid
C. Urea
D. Creatinine
E. Transferrin
25. ECG of a patient with hyperfunction
of thyroid gland showed heart hurry. It is
3
indicated by depression of the following
ECG element:
A. R − R interval
B. P − Q segment
C. P − Q interval
D. P − T interval
E. QRS complex
26. A 62 year woman complai-
ns of frequent pain attacks in the
area of her chest and backbone, rib
fractures. Her doctor suspected myeloma
(plasmocytoma). What of the following
laboratory characteristics will be of the
greatest diagnostic importance?
A. Paraproteinemia
B. Hyperalbuminemia
C. Proteinuria
D. Hypoglobulinemia
E. Hypoproteinemia
27. While playing volleyball a sportsman
made a jump and landed on the outside
edge of his foot. He felt acute pain in the
talocrural joint, active movements are li-
mited, passive movements are unlimited
but painful. A bit later there appeared a
swelling in the area of external ankle, the
skin became red and warm. What type of
peripheral circulation disturbance is the
case?
A. Arterial hyperemia
B. Stasis
C. Embolism
D. Venous hyperemia
E. Thrombosis
28. Bacterioscopic examination of a smear
from the pharynx of a diphtheria suspect
revealed bacilli with volutine granules.
What etiotropic drug should be chosen
in this case?
A. Antidiphtheritic antitoxic serum
B. Bacteriophage
C. Diphtheritic anatoxin
D. Eubiotic
E. Interferon
29. A patient underwent an operation
on account of gall bladder excision that
resulted in obstruction of Ca absorption
through the bowels wall. What vitamin
wil stimulate this process?
 Krok 1 Medicine 2008
A. D3
B. P P
C. C
D. B12
E. K
30. A woman underwent an operation on
account of extrauterine (tubal) pregnancy.
In course of the operation the surgeon
should ligate the branches of the followi-
ng arteries:
A. Uterine and ovarian
B. Superior cystic and ovarian
C. Inferior cystic and ovarian
D. Uterine and superior cystic
E. Uterine and inferior cystic
31. A 6 month old baby ill with bronchitis
was taken for an X-ray of chest. Apart of
changes associated with bronchi the X-ray
film showed a shadow of thymus gland.
What might have caused such changes?
A. The above-mentioned condition is a
normal variant for this age
B. It’s the effect of bronchitis
C. It is caused by abnormal position
D. It is caused by thymus inflammation
E. It is caused by neoplastic process
32. A patient complains of frequent di-
arrheas, especially after consumption of
rich food, weight loss. Laboratory exami-
nation revealed steatorrhea; his feces
were hypocholic. What might have caused
such condition?
A. Obturation of biliary tracts
B. Inflammation of mucous membrane of
small intestine
C. Lack of pancreatic lipase
D. Lack of pancreatic phospholipase
E. Unbalanced diet
33. Examination of a patient with pustular
skin lesions allowed to isolate a causati-
ve agent that forms in the blood agar
roundish yellow middle-sized colonies
surrounded by haemolysis zone. Smears
from the colonies contain irregular-
shaped clusters of gram-positive cocci.
The culture is oxidase- and catalase-
positive, ferments mannitol and synthesi-
zes plasmocoagulase. What causative
agent was isolated?
A. Staphylococcus aureus
B. Streptococcus agalactiae
C. Streptococcus pyogenes
D. Staphylococcus epidermidis
E. Staphylococcus saprophyticus
4
34. A 65 year old man suffering from gout
complains of kidney pain. Ultrasound
examination revealed renal calculi. The
most probable cause of calculi formation
is the strengthened concentration of the
following substance:
A. Uric acid
B. Cholesterol
C. Bilirubin
D. Urea
E. Cystine
35. Microscopic examination of a Gram-
stained scrape from patient’s tongue
revealed oval, round, elongated chains of
dark-violet gemmating cells. What disease
can be caused by this causative agent?
A. Candidosis
B. Actinomycosis
C. Streptococcic infection
D. Staphylococcic infection
E. Diphtheria
36. A 44 year old woman complains of
general weakness, heart pain, significant
increase of body weight. Objectively:
moon face, hirsutism, AP is 165/100 mm
Hg, height - 164 cm, weight - 103 kg; the
fat is mostly accumulated on her neck,
thoracic girdle, belly. What is the main
pathogenetic mechanism of obesity?
A. Increased production of glucocorticoids
B. Reduced production of thyroid
hormones
C. Increased insulin production
D. Reduced glucagon production
E. Increased mineralocorticoid production
37. Blood of a patient with presumable
sepsis was inoculated into sugar broth.
There appeared bottom sediment.
Repeated inoculation into blood agar
caused growth of small transparent round
colonies surrounded by hemolysis zone.
Examination of a smear from the sedi-
ment revealed gram-positive cocci in form
of long chains. What microorganisms are
present in blood of this patient?
A. Streptococci
B. Micrococci
C. Staphylococci
D. Tetracocci
E. Sarcina
38. 2 years ago a patient underwent
resection of pyloric part of stomach. He
complains of weakness, periodical dark
shadows beneath his eyes, dyspnea. In
blood: Hb - 70 g/l, erythrocytes - 3, 0 ·
 Krok 1 Medicine 2008
1012 /l, colour index - 0,7. What changes
of erythrocytes in blood smears are the
most typical for this condition?
A. Microcytes
B. Megalocytes
C. Schizocytes
D. Ovalocytes
E. Macrocytes
39. A patient is ill with hepatocirrhosis.
State of antitoxic liver function can be
characterized by examination of the
following substance exreted by urine:
A. Hippuric acid
B. Ammonium salts
C. Creatinine
D. Uric acid
E. Amino acids
40. The territory of an old burial ground
for animal refuse that hasn’t been used for
over 50 years is meant for house building.
But soil investigation showed the presense
of viable spores of a causative agent causi-
ng a very dangerous disease. What mi-
croorganism might have been preserved
in soil for such a long period of time?
A. Bacillus anthracis
B. Francisella tularensis
C. Brucella abortus
D. Yersinia pestis
E. Mycobacterium bovis
41. Autopsy of a man who had been
working as a miner for many years and di-
ed from cardiopulmonary decompensati-
on revealed that his lungs were ai-
rless, sclerosed, their apexex had
emphysematous changes, the lung surface
was greyish-black, the incised lung ti-
ssue was coal-black. What disease caused
death?
A. Anthracosis
B. Silicosis
C. Talcosis
D. Asbestosis
E. Aluminosis
42. Microscopy of stained (Ziehl-Neelsen
staining) smears taken from the sputum
of a patient with chronic pulmonary di-
sease revealed red bacilli. What property
of tuberculous bacillus was shown up?
5
A. Acid resistance
B. Alkali resistance
C. Alcohol resistance
D. Capsule formation
E. Sporification
43. Parents of a 10 year old boy consulted
a doctor about extension of hair-covering,
growth of beard and moustache, low voi-
ce. Intensified secretion of which hormone
must be assumed?
A. Of testosterone
B. Of somatotropin
C. Of oestrogen
D. Of progesterone
E. Of cortisol
44. Examination of coronary arteries
revealed atherosclerotic calcified plaques
closing vessel lumen by 1/3. The muscle
has multiple whitish layers of connective
tissue. What process was revealed in the
myocardium?
A. Diffusive cardiosclerosis
B. Tiger heart
C. Postinfarction cardiosclerosis
D. Myocarditis
E. Myocardium infarction
45. It was revealed that T-lymphocytes
were affected by HIV. Virus enzyme -
reverse transcriptase (RNA-dependent
DNA polymerase) - catalyzes the
synthesis of:
A. DNA on the matrix of virus mRNA
B. Virus informational RNA on the matrix
of DNA
C. DNA on virus ribosomal RNA
D. Viral DNA on DNA matrix
E. mRNA on the matrix of virus protein
46. A 35 year old man with a trauma
of his left hand was admitted to the
traumatology department. Objectively:
cut wound of palmar surface of left hand;
middle phalanxes of II–V fingers don’t
bend. What muscles are damaged?
A. Superficial finger flexor
B. Profound finger flexor
C. Lumbrical muscles
D. Palmar interosseous muscles
E. Dorsal interosseous muscles
47. Histological examination of a skin
tissue sampling revealed granulomas
consisting of macrophagal nodules with
lymphocytes and plasmatic cells. There
are also some big macrophages with fatty
vacuoles containing causative agents of
 Krok 1 Medicine 2008
a disease packed up in form of spheres
(Virchow’s cells). Granulation tissue is
well vascularized. What disease is this
granuloma typical for?
A. Lepra
B. Tuberculosis
C. Syphilis
D. Rhinoscleroma
E. Glanders
48. In order to estimate toxigenity of di-
phtheria agents obtained from patients
the cultures were inoculated on Petri dish
with nutrient agar on either side of a filter
paper strip that was put into the centre
and moistened with antidiphtheric anti-
toxic serum. After incubation of inoculati-
ons in agar the strip-like areas of medium
turbidity were found between separate
cultures and the strip of filter paper. What
immunological reaction was conducted?
A. Precipitation gel reaction
B. Coomb’s test
C. Agglutination reaction
D. Rings precipitation reaction
E. Opsonization reaction
49. A patient taking clonidine for essenti-
al hypertension treatment was using
alcohol that caused intense inhibition of
central nervous system. What may it be
connected with?
A. Effect potentiating
B. Effect summation
C. Cumulation
D. Intoxication
E. Idiosyncrasy
50. Examination of an ovary specimen
stained by hematoxylin-eosine revealed
a follicle in which follicular epithelium
consisted of 1-2 layers of cubic cells. There
was also a bright red membrane around
the ovocyte. What follicle is it?
A. Primary
B. Primordial
C. Secondary
D. Mature
E. Atretic
51. A patient with clinical signs of
encephalitis was delivered to the infecti-
ous diseases hospital. Anamnesis registers
a tick bite. Hemagglutination-inhibition
reaction helped to reveal antibodies to the
causative agent of tick-borne encephalitis
in the dilution 1:20 which is not diagnostic.
What actions should the doctor take after
he had got such result?
6
A. To repeat the examination with serum
taken 10 days later
B. To examine the same serum
C. To apply more sensitive reaction
D. To repeat examination with another
diagnosticum
E. To deny diagnosis of tick-borne
encephalitis
52. A 40 year old man noticed a reddeni-
ng and an edema of skin in the area
of his neck that later developed into a
small abscess. The incised focus is dense,
yellowish-green. The pus contains whi-
te granules. Histological examination
revealed drusen of a fungus, plasmatic and
xanthome cells, macrophages. What type
of mycosis is the most probable?
A. Actinomycosis
B. Aspergillosis
C. Candidosis
D. Sporotrichosis
E. Coccidioidomycosis
53. Continuous taking of some drugs
foregoing the pregnancy increase the ri-
sk of giving birth to a child with genetic
defects. What is this effect called?
A. Mutagenic effect
B. Embryotoxic effect
C. Teratogenic effect
D. Fetotoxical effect
E. Blastomogenic effect
54. A man with a wound of his limb that
had been suppurating for a long time di-
ed from intioxication. Autopsy revealed
extreme emaciation, dehydration, brown
atrophy of liver, myocardium, spleen and
cross-striated muscles as well as renal
amyloidosis. What diagnosis corresponds
with the described picture?
A. Chroniosepsis
B. Septicopyemia
C. Septicemia
D. Chernogubov’s syndrome
E. Brucellosis
55. 6 months after labour a woman
had uterine hemorrhage. Gynaecologi-
cal examination of uterine cavity revealed
a dark-red tissue with multiple cavities
resembling of a "sponge". Microscopic
examination of a tumour revealed in
blood lacunas atypic light epithelial
Langhans cells and giant cells of syncyti-
otrophoblast. What tumour is it?
 Krok 1 Medicine 2008 7

A. Chorioepithelioma 61. A patient suffering from chronic

B. Squamous cell nonkeratinous carci- cardiac insufficiency was recommended
noma to undergo a prophylactic course of
C. Adenocarcinoma treatment with a cardiological drug from
D. Fibromyoma the group of cardiac glycosides that is
E. Cystic mole to be taken enterally. What drug was
recommended?
56. An animal with aortic valve insuffi-
ciency got hypertrophy of its left A. Digoxin
heart ventricle. Some of its parts have B. Strophanthine
local contractures. What substance C. Corglycon
accumulated in the myocardiocytes D. Cordiamin
caused these contractures? E. Cordarone
A. Calcium 62. An ophthalmologist used a 1%
B. Potassium mesaton solution for the diagnostic
C. Lactic acid purpose (pupil dilation for eye-ground
D. Carbon dioxide examination). What is the cause of mydri-
E. Sodium asis induced by the drug?
57. A girl is diagnosed with adrenogeni- A. Activation of α1 adrenoreceptors
tal syndrome (pseudohermaphroditi- B. Activation of α2 adrenoreceptors
sm). This pathology was caused by C. Block of α1 adrenoreceptors
hypersecretion of the following adrenal D. Activation of β1 adrenoreceptors
hormone: E. Activation of M-cholinoreceptors
A. Androgen 63. Prophylactic medical examination of
B. Estrogen a 36 year old driver revealed that his
C. Aldosterone AP was 150/90 mm Hg. At the end of
D. Cortisol working day he usually hears ear noi-
E. Adrenalin se, feels slight indisposition that passes
after some rest. He was diagnosed with
58. In course of an experiment a big essential hypertension. What is the leadi-
number of stem cells of red bone marrow ng pathogenetic mechanism in this case?
was in some way destructed. Regenerati-
on of which cell populations in the loose A. Neurogenetic
connective tissue will be inhibited? B. Nephric
C. Humoral
A. Of macrophags D. Endocrinal
B. Of fibroblasts E. Reflexogenic
C. Of pigment cells
D. Of lipocytes 64. A cerebral trauma caused increased
E. Of pericytes ammonia generation. What amino acid
participates in the excretion of ammonia
59. Examination of a 70 year old pati- from the cerebral tissue?
ent rrevealed insulin-dependent diabetes.
What drug should be administered? A. Glutamic
B. Tyrosine
A. Glibenclamid C. Valine
B. Insulin D. Tryptophan
C. Mercazolilum E. Lysine
D. Parathyroidin
E. Cortisone 65. While studying maximally spiralized
chromosomes of human karyotype the
60. A human body cools in water much process of cell division was stopped in the
faster that in the air. What way of heat following phase:
emission in water is much more efficient?
A. Metaphase
A. Heat conduction B. Prophase
B. Convection C. Interphase
C. Heat radiation D. Anaphase
D. Sweat evaporation E. Telophase
E. -
 Krok 1 Medicine 2008
66. 48 hours after tuberculine test
(Mantoux test) a child had a papule 10
mm in diameter on the spot of tuberculine
injection. What hypersensitivity mechani-
sm underlies these changes?
A. Cellular cytotoxicity
B. Anaphylaxy
C. Antibody-dependent cytotoxicity
D. Immunocomplex cytotoxicity
E. Granulomatosis
67. A patient was admitted to the surgical
department with suspected inflammation
of Meckel’s diverticulum. What part of
bowels should be examined in order to
discover the diverticulum in course of an
operation?
A. Ileum
B. Duodenum
C. Jejunum
D. Caecum
E. Colon ascendens
68. Power inputs of a man were measured.
In what state was this man if his power
inputs were lower than basal metabolism?
A. Sleep
B. Relaxation
C. Simple work
D. Nervous tension
E. Rest
69. Examination of a newborn boy’s geni-
talia revealed an urethral hiatus that
opens on the undersite of his penis. What
malformation is it?
A. Hypospadias
B. Hermaphroditism
C. Epispadia
D. Monorchism
E. Cryptorhidism
70. A concentrated solution of sodium
chloride was intravenously injected to an
animal. This caused decreased reabsorpti-
on of sodium ions in the renal tubules. It
is the result of the following changes of
hormonal secretion:
A. Aldosterone reduction
B. Aldosterone increase
C. Vasopressin reduction
D. Vasopressin increase
E. Reduction of atrial natriuretic factor
71. As a result of destruction of certain
brainstem structures an animal has lost
its orientative reflexes in response to
strong photic stimuli. What structures
8
were destroyed?
A. Anterior tubercles of quadrigeminal
plate
B. Posterior tubercles of quadrigeminal
plate
C. Red nuclei
D. Vestibular nuclei
E. Black substance
72. Myocyte cytoplasm contains a big
number of dissolved metabolites of
glucose oxidation. Name one of them that
turns directly into a lactate:
A. Pyruvate
B. Oxaloacetate
C. Glycerophosphate
D. Glucose 6-phosphate
E. Fructose 6-phosphate
73. Mother of a 2 year old child
consulted a stomatologist. In the peri-
od of pregnancy she was irregularly taki-
ng antibiotics for an infectious disease.
Examination of the child revealed inci-
sor destruction, yellow enamel, brown rim
around the dental cervix. What drug has
apparent teratogenic effect?
A. Doxacycline
B. Furosemide
C. Ampiox
D. Xantinol nicotinate
E. Octadine
74. 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 mechani-
sms of stenocardia development is the
leading in this case?
A. High catecholamine concentration in
blood
B. Coronary atherosclerosis
C. Intravascular aggregation of blood
corpuscles
D. Coronary thrombosis
E. Functional heart overload
75. A patient recovered from Sonne
dysentery and was once more infected wi-
th the same causative agent. What is such
infection form called?
A. Reinfection
B. Recidivation
C. Superinfection
D. Persisting infection
E. Chronic infection
 Krok 1 Medicine 2008
76. 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 forestomach. In
blood: Hb- 80 g/l; erythrocytes - 2, 0·1012 /l;
colour index - 1,2, leukocytes - 3, 5 · 109 /l.
What anemia type is it?
A. B12 -folate deficient
B. Hemolytic
C. Posthemorrhagic
D. Aplastic
E. Iron-deficient
77. A 35 year old patient applied to
a doctor with complaints about havi-
ng intense rhinitis and loss of sense of
smell for a week. Objectively: nasal cavi-
ty contains a lot of mucus that covers
mucous membrane and blocks olfactory
receptors. In what part of nasal cavity are
these receptors situated?
A. Superior nasal turbinate
B. Median nasal turbinate
C. Inferior nasal turbinate
D. Common nasal meatus
E. Vestibule of nose
78. A 17 year old boy fell seriously ill,
the body temperature rose up to 38, 5oC,
there appeared cough, rhinitis, lacrimati-
on, nasal discharges. What inflammation
is it?
A. Catarrhal
B. Serous
C. Fibrinous
D. Purulent
E. Hemorrhagic
79. A patient with disturbed cerebral ci-
rculation has problems with deglutition.
What part of brain was damaged?
A. Brainstem
B. Cervical part of spinal cord
C. Forebrain
D. Interbrain
E. Midbrain
80. Vitamin B1 deficiency results in di-
sturbance of oxidative decarboxylation
of α-ketoglutaric acid. This will disturb
synthesis of the following coenzyme:
9
A. Thiamine pyrophosphate
B. Nicotinamide adenine dinucleotide
(NAD)
C. Flavine adenine dinucleotide (FAD)
D. Lipoic acid
E. Coenzyme A
81. A chemical burn caused esophagus
stenosis. Difficulty of ingestion led to the
abrupt loss of weight. In blood: 3, 0 · 1012/l,
Hb - 106 g/l, crude protein - 57 g/l. What
type of starvation is it?
A. Incomplete
B. Proteinic
C. Complete
D. Water
E. Absolute
82. A 30 year old woman has face
edemata. Examination revealed protei-
nuria (5,87 g/l), hypoproteinemia,
dysproteinemia, hyperlipidemia. What
condition is the set of these symptoms
typical for?
A. Nephrotic syndrome
B. Nephritic syndrome
C. Chronic pyelonephritis
D. Acute renal failure
E. Chronic renal failure
83. Skin of a man who died from cardi-
ac insufficiency has an eruption in form
of spots and specks. There are also
bedsores in the area of sacrum and spi-
nous vertebral processes. Microscopical
examination of CNS, skin, adrenal glands
revealed in the vessels of microcirculatory
bed and in small arteries destructive-
proliferative endothrombovasculitis with
Popov’s granulomas; interstitial myocardi-
tis. What diagnosis corresponds with the
described picture?
A. Spotted fever
B. Q fever
C. Enteric fever
D. Nodular periarteritis
E. HIV
84. Autopsy of a man who died from
the sepsis in his femoral bone revealed
phlegmonous inflammation that affected
the marrow, haversian canals and peri-
osteum. Under the periosteum there are
multiple abscesses, adjoining soft tissues
of thigh also have signs of phlegmonous
inflammation. What pathological process
was described?
 Krok 1 Medicine 2008
A. Acute hematogenous osteomyelitis
B. Osteoporosis
C. Chronic hematogenous osteomielitis
D. Osteopetrosis
E. -
85. A patient has a decreased vasopressin
synthesis that causes polyuria and as a
result of it evident organism dehydratati-
on. What is the mechanism of polyuria
development?
A. Reduced tubular reabsorption of water
B. Reduced tubular reabsorption of Na
ions
C. Reduced tubular reabsorption of
protein
D. Reduced glucose reabsorption
E. Acceleration of glomerular filtration
86. A patient with nephrotic syndrome
has massive edemata of his face and li-
mbs. What is the leading pathogenetic
mechanism of edemata development?
A. Drop of oncotic blood pressure
B. Increase of vascular permeability
C. Rise of hydrodynamic blood pressure
D. Lymphostasis
E. Increase of lymph outflow
87. Examination of a 55 year old woman
revealed under the skin of submandi-
bular area a movable slowly growing pasty
formation with distinct borders 1,0x0,7 cm
large. Histological examination revealed
lipocytes that form segments of diffrent
forms and sizes separated from each other
by thin layers of connective tissue with
vessels. What is the most probable di-
agnosis?
A. Lipoma
B. Fibroma
C. Angioma
D. Liposarcoma
E. Fibrosarcoma
88. An unconscious young man with signs
of morphine poisoning entered admissi-
on office. His respiration is shallow and
infrequent which is caused by inhibition
of respiratory centre. What type of respi-
ratory failure is it?
A. Ventilative dysregulatory
B. Ventilative obstructive
C. Ventilative restrictive
D. Perfusive
E. Diffusive
89. A patient with cholelithiasis fell
ill with mechanic jaundice. Examinati-
10
on revealed that the stone was in the
common bile duct. What bile-excreting
ducts make up the obturated duct?
A. Ductus hepaticus communis et ductus
cysticus
B. Ductus hepaticus dexter et sinister
C. Ductus hepaticus dexter et ductus cysti-
cus
D. Ductus hepaticus sinister et ductus
cysticus
E. Ductus hepaticus communis et ductus
choledochus
90. A patient is 44 years old. Laboratory
examination of his blood revealed that
content of proteins in plasma was 40 g/l.
What influence will be exerted on the
transcapillary water exchange?
A. Filtration will be increased, reabsorpti-
on - decreased
B. Both filtration and reabsorption will be
increased
C. Both filtration and reabsorption will be
decreased
D. Filtration will be decreased, reabsorpti-
on - increased
E. Exchange will stay unchanged
91. The cerebrospinal fluid is being exami-
ned for the purpose of diffrential meningi-
tis diagnostics. At what site is the lumbal
puncture safe?
A. L III-L IV
B. L II-L III
C. L I-L II
D. Th XII-L I
E. L V-S I
92. An isolated cell of human heart
automatically generates excitement
impulses with frequency of 60 times per
minute. This cell was taken from the
following heart structure:
A. Sinoatrial node
B. Atrium
C. Ventricle
D. Atrioventricular node
E. His’ bundle
93. Examination of a 60 year old patient
revealed hyperglycemia and glucosuria. A
doctor administered him a medication for
internal use. What medication is it?
A. Glibenclamid
B. Furosemide
C. Oxytocin
D. Pancreatine
E. Corglycon
 Krok 1 Medicine 2008 11

94. As a result of posttranslative modifi- crospcopic examination of scrapings from

cations some proteins taking part in blood the affected areas revealed living porrect
coagulation, particularly prothrombin, vermiform arthropoda 0,2-0,5 mm large
become capable of calcium binding. with four pairs of short extremities in the
The following vitamin takes part in this front part of their bodies. What is the
process: laboratory diagnosis?
A. K A. Demodicosis
B. C B. Scabies
C. A C. Myiasis
D. B1 D. Pediculosis
E. B2 E. Phthiriasis
95. Examination of a man who had been 100. A 28 year old man had a gunshot
working hard under higher temperature wound of shin that resulted in an
of the environment revealed abnormal ulcer from the side of the injury. What
quantity of blood plasma proteins. What is the main factor of neurodystrophy
phenomenon is the case? pathogenesis in this case?
A. Relative hyperproteinemia A. Traumatization of peripheral nerve
B. Absolute hyperproteinemia B. Psychical stress
C. Absolute hypoproteinemia C. Microcirculation disturbance
D. Dysproteinemia D. Infection
E. Paraproteinemia E. Tissue damage
96. A patient ill with thrombophlebitis of 101. A 45 year old man consulted a doctor
his lower limbs had chest pain, blood spi- about a plaque-like formation on his neck.
tting, progressing respiratory insufficiency Histological examination of a skin bi-
that led to his death. Autopsy diagnosed optate revealed clusters of round and
multiple lung infarctions. What is the most oval tumour cells with a narrow border of
probable cause of their development? basophilic cytoplasm resembling of cells
of basal epidermal layer. What tumour is
A. Thromboembolism of pulmonary artery it?
branches
B. Thrombosis of pulmonary artery A. Basal cell carcinoma
branches B. Epidermal cancer
C. Thrombosis of bronchial arteries C. Hydroadenoma
D. Thromboembolism of bronchial arteries D. Trichoepithelioma
E. Thrombosis of pulmonary veins E. Syringoadenoma
97. A woman suffering from osteochondrosis 102. A patient ill with essential
felt acute pain in her humeral articulation hypertension was recommended a drug
that became stronger when she abducted that prevents thrombosis. It is to be taken
her shoulder. These symptoms might be parenterally. What drug is it?
caused by damage of the following nerve:
A. Heparin
A. Axillary nerve B. Amben
B. Subscapular nerve C. Protamine sulfate
C. Dorsal scapular nerve D. Neodicumarin
D. Subclavicular nerve E. Syncumar
E. Throracodorsal nerve
103. Packed cell volume of a man was
98. A patient has a deep cut wound on the 40% before the trauma. What packed cell
posterior surface of his shoulder in its mi- volume will be observed 24 hours after
ddle third. What muscle might be injured? blood loss of 750 ml?
A. Triceps muscle of arm A. 30%
B. Biceps muscle of arm B. 40%
C. Anconeus muscle C. 55%
D. Brachial muscle D. 45%
E. Coracobrachial muscle E. 50%
99. A patient has acne on his face. Mi- 104. Two hours after an exam a student
 Krok 1 Medicine 2008
had a blood count done and it was
revealed that he had leukocytosis wi-
thout significant leukogram modifications.
What is the most probable mechanism of
leukocytosis development?
A. Redistribution of leukocytes in the
organism
B. Leukopoiesis intensification
C. Deceleration of leukocyte lysis
D. Deceleration of leukocyte migration to
the tissues
E. Leukopoiesis intensification and
deceleration of leukocyte lysis
105. Golgi complex exports substances
from a cell due to the fusion of
the membrane saccule with the cell
membrane. The saccule contents flows
out. What process is it?
A. Exocytosis
B. Endocytosis
C. Active transport
D. Facilitated diffusion
E. All answers are false
106. A boy found a spider with the followi-
ng morphological characteristics: it is 2 cm
long, has roundish black abdomen with
two rows of red spots on its dorsal side;
four pairs of jointed limbs are covered wi-
th small black hairs. What arthropod is it?
A. Karakurt spider
B. Scorpion
C. Solpuga
D. Mite
E. Tarantula
107. A 3 year old child with symptoms
of stomatitis, gingivitis and dermati-
tis of open skin areas was delivered
to a hospital. Examination revealed
inherited disturbance of neutral amino
acid transporting in the bowels. These
symptoms were caused by the deficiency
of the following vitamin:
A. Niacin
B. Pantothenic acid
C. Vitamin A
D. Cobalamin
E. Biotin
108. A patient with suspected diagnosis
"progressing muscular dystrophy"got his
urine tested. What compound will confirm
this diagnosis if found in urine?
12
A. Kreatine
B. Collagen
C. Porphyrin
D. Myoglobin
E. Calmodulin
109. A patient being treated for viral
hepatitis type B got symptoms of hepatic
insufficiency. What blood changes indi-
cative of protein metabolism disorder will
be observed in this case?
A. Absolute hypoalbuminemia
B. Absolute hyperalbuminemia
C. Absolute hyperfibrinogenemia
D. Proteinic blood composition is
unchanged
E. Absolute hyperglobulinemia
110. A pregnant woman had her blood
group identified. Reaction of erythrocyte
agglutination with standard serums of 0αβ
(I), Bα (III) groups didn’t proceed wi-
th standard serum of Aβ (II) group. The
blood group under examination is:
A. Аβ (II)
B. 0αβ (I)
C. Вα (III)
D. АВ (IV)
E. -
111. A sensitive neural ganglion consists
of roundish neurocytes with one extensi-
on that divides into axon and dendrite at
some distance from the perikaryon. What
are these cells called?
A. Pseudounipolar
B. Unipolar
C. Bipolar
D. Multipolar
E. Apolar
112. A 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]-dichydroxycholecalciferol
B. Biotin
C. Tocopherol
D. Naphtaquinone
E. Retinol
113. An embryo displays disturbed
process of dorsal mesoderm segmentation
and somite formation. What part of skin
will have developmental abnormalities?
 Krok 1 Medicine 2008 13

A. Derma are being stimulated in course of an

B. Hair experiment. As a result of it the exci-
C. Sebaceous glands tement conduction from atria to the
D. Epidermis ventricles was brought to a stop. It is
E. Sudoriferous glands caused by electrophysical changes in the
following structures:
114. It was found out that some
compounds, for instance fungi toxins and A. Atrioventricular node
some antibiotics can inhibit activity of B. His’ bundle
RNA-polymerase. What process will be C. Sinoatrial node
disturbed in a cell in case of inhibition of D. Ventricles
this enzyme? E. Atria
A. Transcription 119. If a man has an attack of bronchi-
B. Processing ospasm it is necessary to reduce the effect
C. Replication of vagus on smooth muscles of bronchi.
D. Translation What membrane cytoreceptors should be
E. Reparation blocked for this purpose?
115. A 7 year old child is ill with A. M-cholinoreceptors
bronchitis. It is necessary to administer B. N-cholinoreceptors
him an antibacterial drug. What drug C. α-adrenoreceptors
of fluoroquinolone group is CONTRA- D. β-adrenoreceptors
INDICATED at this age? E. α- and β-adrenoreceptors
A. Cyprofloxacin 120. A patient of surgical department
B. Ampicillin complains about pain in the small of her
C. Amoxicillin back and in the lower part of her belly;
D. Sulfadimethoxine painful and frequent urination. Bacteri-
E. Ampiox ological examination of urine revealed
gram-negative oxidase-positive rod-like
116. A culture of monkey cells (Vero) and bacteria forming greenish mucoid coloni-
a group of mouse sucklings were infected es with specific smell. What causative
with an inoculum taken from a child with agent can it be?
provisional diagnosis "enterovirus infecti-
on". There was no cytopathic effect on A. Pseudomonas aeruginosa
the cell culture but mouse sucklings died. B. Proteus mirabilis
What enteric viruses might have caused C. E.coli
disease of this child? D. Str.pyogenes
E. Mycoplasma pneumonie
A. Coxsackie A
B. Coxsackie B 121. There are several groups of
C. ECHO virus molecular mechanisms playing important
D. Polioviruses part in pathogenesis of insult to cells
E. Unclassified enteric viruses 68-71 which contributes to the pathology
development. What processes are sti-
117. A patient died from cardiopulmonary mulated by proteinic damage mechani-
decompensation. Histological examinati- sms?
on revealed diffused pulmonary lesi-
on together with interstitial edema, A. Enzyme inhibition
infiltration of tissue by limphocytes, B. Lipid peroxidation
macrophages, plasmocytes; pulmonary fi- C. Phospholipase activation
brosis, panacinar emphysema. What di- D. Osmotic membrane distension
sease corresponds with the described pi- E. Acidosis
cture?
122. A child was born with cleft palate.
A. Fibrosing alveolitis Examination revealed aorta defects and
B. Chronic bronchitis reduced number of T-lymphocytes in
C. Bronchopneumonia blood. What immunodeficient syndrome
D. Pulmonary atelectasis is it?
E. Bronchial asthma
118. Vagus branches that innervate heart
 Krok 1 Medicine 2008 14

A. DiGeorge A. Inherited, dominant

B. Wiskott-Aldrich B. Inherited, recessive
C. Chediak-Higashi C. Inherited, sex-linked
D. Louis-Bar D. Congenital
E. Swiss-type E. Acquired
123. A 16 year old boy after an illness has 128. A patient was diagnosed with autoi-
diminished function of protein synthesis mmune hemolitic cytotoxic anemia. What
in liver as a result of vitamin K deficiency. substances are antigens in II type allergic
It will cause disturbance of: reactions?
A. Blood coagulation A. Modified receptors of cell membranes
B. Erythrocyte sedimentation rate B. Antibiotics
C. Anticoagulant generation C. Hormones
D. Erythropoietin secretion D. Serum proteins
E. Osmotic blood pressure E. Inflammation modulators
124. Life cycle of a cell includes the 129. While performing an operation in the
process of DNA autoreduplication. As a area of axillary crease a surgeon has to
result of it monochromatid chromosomes define an arterial vessel surrounded by
turn into bichromatid ones. What period fascicles of brachial plexus. What artery is
of cell cycle does this phenomenon fall it?
into?
A. A.axillaris
A. S B. A.vertebralis
B. Go C. A.transversa colli
C. G1 D. A.profunda brachii
D. G2 E. A.subscapularis
E. M
130. A patient takes digoxin for treatment
125. A driver who got a trauma in a road of cardiac insufficiency. What diuretic
accident and is shocked has reduction of may increase digoxin toxicity due to the
daily urinary output down to 300 ml. What intensified excretion of K + ions?
is the main pathogenetic factor of such di-
uresis change? A. Hydrochlorothiazide
B. Spironolactone
A. Drop of arterial pressure C. Panangine
B. Drop of oncotic blood pressure D. Siliborum
C. Increased vascular permeability E. Lisinopril
D. Decreased number of functioning
glomerules 131. During starvation muscle proteins
E. Secondary hyperaldosteronism break up into free amino acids. These
compounds will be the most probably
126. Systemic arterial pressure of an adult involved into the following process:
dropped from 120/70 to 90/50 mm Hg
that led to reflectory vasoconstriction. The A. Gluconeogenesis in liver
vasoconstriction will be maximal in the B. Gluconeogenesis in muscles
following organ: C. Synthesis of higher fatty acids
D. Glycogenolysis
A. Bowels E. Decarboxylation
B. Heart
C. Brain 132. A patient ill with amebiasis was
D. Kidneys prescribed a certain drug. The use of
E. Adrenals alcohol together with this drug is contra-
indicated because the drug inhibits
127. Examination of a 12 year old metabolism of ethyl alcohol. What drug
boy with developmental lag revealed is it?
achondroplasia: disproportional consti-
tution with evident shortening of upper A. Metronidazole
and lower limbs as a result of growth B. Reserpine
disorder of epiphyseal cartilages of long C. Clonidine
tubal bones. This disease is: D. Diazepam
E. Aminazine
 Krok 1 Medicine 2008
133. Surgical removal of a part of stomach
resulted in disturbed absorption of vi-
tamin B12 , it is excreted with feces. The
patient was diagnosed with anemia. What
factor is necessary for absorption of this
vitamin?
A. Gastromucoprotein
B. Gastrin
C. Hydrochloric acid
D. Pepsin
E. Folic acid
134. A patient ill with chronic cardi-
ac insufficiency was prescribed an
average therapeutic dose of digoxin. Two
weeks after begin of its taking there
appeared symptoms of drug intoxication
(bradycardia, extrasystole, nausea). Name
the phenomenon that caused accumulati-
on of the drug in the organism?
A. Material cumulation
B. Functional cumulation
C. Tolerance
D. Tachyphylaxis
E. Idiosyncrasy
135. In course of a preventive exami-
nation 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?
A. Myocardium hypertrophy
B. Tachycardia
C. Rise of arterial pressure
D. Dyspnea
E. Cyanosis
136. Rest potential of a cell equals −80
mV . At what stage of action potential did
the membrane potential equal +30 mV ?
A. Reverse polarization
B. After hyperpolarization
C. After depolarization
D. Depolarization
E. -
137. A 35 year old man got an injury
that caused complete disruption of spi-
nal cord at the level of the first cervical
segment. What respiration changes will
be observed?
15
A. It will come to a standstill
B. No changes will be observed
C. Diaphragmal respiration will be mai-
ntained, thoracic respiration will disappear
D. Thoracic respiration will be maintained,
diaphragmal respiration will disappear
E. It will become infrequent and deep
138. In course of an experiment a peri-
pheral section of vagus of an expiremental
animal is being stimulated. What changes
will be observed?
A. Heart rate fall
B. Heart hurry
C. Pupil dilation
D. Increase of respiration rate
E. Bronchi dilation
139. 2 hours after a skeletal extension
was performed to a 27 year old patient
with multiple traumas (closed injury of
chest, closed fracture of right thigh) his
condition abruptly became worse and the
patient died from acute cardiopulmonary
decompensation. Histological examinati-
on of pulmonary and cerebral vessels stai-
ned with Sudan III revealed orange drops
occluding the vessel lumen. What compli-
cation of polytrauma was developed?
A. Fat embolism
B. Gaseous embolism
C. Microbal embolism
D. Thromboembolism
E. Air embolism
140. In course of severe respiratory vi-
ral infection there appeared clinical si-
gns of progressing cardiac insufficiency
that caused death of a patient in the 2nd
week of disease. Autopsy revealed that
the heart was sluggish, with significant
cavity dilatation. Histological examinati-
on of myocardium revealed plephora of
microvessels and diffuse infiltration of
stroma by lymphocytes and histiocytes.
What disease corresponds with the descri-
bed picture?
A. Myocarditis
B. Stenocardia
C. Acute coronary insufficiency
D. Myocardium infarction
E. Cardiomyopathy
141. A specimen stained by Ozheshko
method contains rod-like microorgani-
sms stained blue with round terminal
components stained red. What are these
components called?
 Krok 1 Medicine 2008
A. Spores
B. Cilia
C. Flagella
D. Capsules
E. Mesosomas
142. A 38 year old patient with full-blown
jaundice, small cutaneous hemorrhages,
general weakness and loss of appetite
underwent puncture biopsy of liver. Hi-
stological examination revealed dissemi-
nated dystrophy, hepatocyte necrosis,
Councilman’s bodies. Lobule periphery
has signs of significant infiltration by
lymphocytes, there are also individual
multinuclear hepatocytes. What is the
most probable diagnosis?
A. Acute viral hepatitis
B. Acute alcoholic hepatitis
C. Miliary hepatic cirrhosis
D. Toxic degeneration of liver
E. Chronic hepatitis
143. A man with an injury of the dorsal
area of his neck was admitted to the
resuscitation department. What muscle
occupies this area?
A. M.trapezius
B. M.sternocleidomastoideus
C. M.latissimus dorsi
D. M.rhomboideus minor
E. M.scalenus anterior
144. In course of an experiment a toad’s
right labyrinth was destroyed. It will cause
amyotonia of the following muscles:
A. Right extensors
B. Left flexors
C. Left extensors
D. Right flexors
E. Right and left extensors
145. A 20 year old patient died from
intoxication 8 days after artificial illegal
abortion performed in her 14-15th
week of pregnancy. Autopsy of the
corpse revealed yellowish colour of eye
sclera and of skin, necrotic suppurati-
ve endometritis, multiple pulmonary
abscesses, spleen hyperplasia with a big
number of neutrophils in its sinuses.
What complication after abortion was
developed?
A. Septicopyemia
B. Septicemia
C. Hemorrhagic shock
D. Chroniosepsis
E. Viral hepatitis type A
16
146. A patient complains of dizziness and
hearing loss. What nerve is damaged?
A. Vestibulocochlear
B. Trigeminus
C. Sublingual
D. Vagus
E. Trochlear
147. A 6 year old child was delivered to a
hospital. Examination revealed that the
child couldn’t fix his eyes, didn’t keep
his eyes on toys, eye ground had the
cherry-red spot sign. Laboratory analyses
showed that brain, liver and spleen had hi-
gh rate of ganglioside glycometide. What
congenital disease is the child ill with?
A. Tay-Sachs disease
B. Wilson’s syndrome
C. Turner’s syndrome
D. Niemann-Pick disease
E. MacArdle disease
148. A patient has a cluster of matted
together dense lymph nodes on his neck.
Histological examination of a removed
lymph node revealed proliferation of reti-
cular cells, presense of Reed-Sternberg
cells. What disease is meant?
A. Lymphogranulomatosis
B. Lymphoblastic leukosis
C. Myeloblastic leukosis
D. Myelocytic leukosis
E. Lymphocytic leukosis
149. While palpating mammary gland of a
patient a doctor revealed an induration
in form of a node in the inferior medial
quadrant. Metastases may extend to the
following lymph nodes:
A. Parasternal
B. Posterior mediastinal
C. Profound lateral cervical
D. Bronchopulmonary
E. Superior diaphragmal
150. A pregnant woman was registered
in an antenatal clinic and underwent
complex examination for a number of
infections. Blood serum contained IgM
to the rubella virus. What is this result
indicative of?
A. Of primary infection
B. Of a chronic process
C. The woman is healthy
D. Of exacerbation of a chronic disease
E. Of recurring infection with rubella virus
151. Parents of a 3 year old child have
 Krok 1 Medicine 2008
been giving him antibiotics with purpose
of preventing enteric infections for a long
time. A month later the child’s conditi-
on changed for the worse. Blood exami-
nation revealed apparent leukopenia
and granulocytopenia. What is the most
probable mechanism of blood changes?
A. Myelotoxic
B. Autoimmune
C. Redistributive
D. Age-specific
E. Hemolytic
152. A pathological process in bronchi
resulted in epithelium desquamation.
What cells will regenerate bronchial epi-
thelium?
A. Basal
B. Intercalary
C. Ciliate
D. Endocrinal
E. Goblet
153. A patient ill with tuberculosis di-
ed from progressing cardiopulmonary
decompensation. Autopsy in the area of
the right lung apex revealed a cavity 5 cm
in diameter communicating with lumen
of a segmental bronchus. On the insi-
de cavity walls are covered with caseous
masses with epithelioid and Langhans
cells beneath them. What morphological
form of tuberculosis is it?
A. Acute cavernous tuberculosis
B. Tuberculoma
C. Caseous pneumonia
D. Infiltrative tuberculosis
E. Acute focal tuberculosis
154. Workers of a hothouse farm work
under conditions of unfavourable mi-
croclimate: air temperature is +37oC,
relative humidity is 90%, air speed is 0,2
m/s. The way of heat emission under these
conditions will be:
A. Evaporation
B. Heat conduction
C. Convection
D. Radiation
E. All the ways
155. A gynaecologist was examining a
patient and revealed symptoms of genital
tract inflammation. A smear from vagi-
na contains pyriform protozoa with a spi-
ne, flagella at their front; there is also an
undulating membrane. What disease can
be suspected?
17
A. Urogenital trichomoniasis
B. Lambliasis
C. Intestinal trichomoniasis
D. Toxoplasmosis
E. Balantidiasis
156. A boy has I (I 0 I 0 ) blood group and
his sister has IV (I A I B ) blood group. What
blood groups do their parents have?
A. II (I I 0 ) and III (I I 0 )
B. II (I I ) and III (I I 0 )
C. I (I 0 I 0 ) and IV (I A I B )
D. III (I I 0 ) and IV (I A I B )
E. I (I 0 I 0 ) and III (I I 0 )
157. A patient ill with enteritis accompani-
ed by massive diarrhea has low water rate
in the extracellular space, high water rate
inside the cells and low blood osmolari-
ty. What is such disturbance of water-
electrolytic metabolism called?
A. Hypo-osmolar hypohydration
B. Hyperosmolar hypohydration
C. Osmolar hypohydration
D. Hypo-osmolar hyperhydration
E. Hyperosmolar hyperhydration
158. For the purpose of myocardium
infarction treatment a patient was injected
with embryonal stem cells derived from
this very patient by means of therapeutic
cloning . What transplantation type is it?
A. Autotransplantation
B. Allotransplantation
C. Xenotransplantation
D. Isotransplantation
E. Heterotransplantation
159. A histological specimen of spleen
shows a vessel with a wall consisting of
endothelium and subendothelial layer,
median membrane is absent, exterior
membrane inosculates with the layers of
spleen connective tissue. What vessel is it?
A. Vein of non-muscular type
B. Vein of muscular type
C. Artery of muscular type
D. Arteriole
E. Capillary
160. In course of a conditional experiment
the development of mesenchyma cells
was completely inhibited. Development
of the following muscular tissue will be di-
sturbed:
 Krok 1 Medicine 2008
A. Smooth muscular tissue
B. Neural muscular tissue
C. Epidermal muscular tissue
D. Cardiac muscular tissue
E. Skeletal muscular tissue
161. A patient ill with chronic gastri-
tis went for endogastric pH-metry that
allowed to reveal decreased acidity of
gastric juice. It is indicative of diminished
function of the following cells:
A. Parietal exocrinocytes
B. Chief exocrinocytes
C. Endocrinocytes
D. Cervical cells
E. Accessory cells
162. Vagi of an experimental animal
were cut on both sides. What respirati-
on changes will be observed?
A. It will become deep and infrequent
B. It will become shallow and frequent
C. It will become deep and frequent
D. It will become shallow and infrequent
E. No changes will be observed
163. A 70 year old man is ill with
vascular atherosclerosis of lower extremi-
ties and coronary heart disease. Exami-
nation revealed disturbance of lipidic
blood composition. The main factor of
atherosclerosis pathogenesis is the excess
of the following lipoproteins:
A. Low-density lipoproteins
B. Cholesterol
C. High-density lipoproteins
D. Intermediate density lipoproteins
E. Chylomicrons
164. On the 2-3rd day after stomach
resection intestinal peristalsis wasn’t
restored. What is to be administered for
stimulation of gastrointestinal tract?
A. Proserin
B. Prasosin
C. Cyclodole
D. Atropine sulfate
E. Acetylcholine
165. A cardiac electric stimulator was
implanted to a 75 year old man with
heart rate of 40 bpm. Thereafter the heart
rate rose up to 70 bpm. The electric sti-
mulator has undertaken the function of
the following heart part:
18
A. Sinoatrial node
B. Atrioventricular node
C. His’ bundle branches
D. His’ bundle fibers
E. Purkinje’s fibers
166. A stomatologist injected a patient wi-
th a certain drug in order to reduce sali-
vation during tooth filling. What drug is it?
A. Atropine sulfate
B. Adrenaline hydrochloride
C. Proserin
D. Pilocarpine hydrochloride
E. Mesaton
167. A 30 year old woman has applied
a lipstick with a fluorescent substance
for a long time. Then she got a limited
erythema and slight peeling on her lip
border, later there appeared transversal
striae and cracks. Special methods of mi-
croscopic examination of the affected area
helped to reveal sensibilized lymphocytes
and macrophages in the connective tissue;
cytolysis. What type of immunological
hypersensitivity was developed?
A. IV type (cellular cytotoxicity)
B. I type (reaginic)
C. II type (antibody cytotoxicity)
D. III type (immune complex cytotoxicity)
E. Granulomatosis
168. A patient ill with essential arterial
hypertension had a hypertensic crisis that
resulted in an attack of cardiac asthma.
What is the leading mechanism of cardiac
insufficiency in this case?
A. Heart overload caused by high pressure
B. Heart overload caused by increased
blood volume
C. Absolute coronary insufficiency
D. Myocardium damage
E. Blood supply disturbance
169. A man who has been taking a
drug for a long time cannot withhold it
because this causes impairment of psychic,
somatic and vegetative functions. Name
the syndrome of different disturbances
caused by drug discontinuation:
A. Abstinence
B. Sensibilization
C. Idiosyncrasy
D. Tachyphylaxis
E. Cumulation
170. A patient consulted a stomatologist
about purulent inflammation of his gums.
What drug will be the most effective if it
 Krok 1 Medicine 2008
is suspected that a causative agent is an
anaerobe?
A. Metronidazole
B. Gentamicin
C. Oxacillin sodium
D. Co-trimoxazole
E. Nitroxoline
171. Rats being under stress have
muscular hypertonia and high arterial
pressure, high glucose concentration in
blood and intensified secretion of corti-
cotropin and corticosteroids. In what
stress phase are these animals?
A. Antishock phase
B. Exhaustion
C. Shock phase
D. Erectile
E. Terminal
172. Ultramicroscopical examination of
"dark"hepatocyte population in the cell
cytoplasm detected a developed granular
endoplasmic reticulum. What function has
this organella in these cells?
A. Synthesis of blood plasma proteins
B. Carbohydrate synthesis
C. Deintoxicative function
D. Bile production
E. Calcium ion depositing
173. A patient came to the hospital
complaining about quick fatigability and
apparent muscle weakness. Examinati-
on revealed an autoimmune disease that
causes disorder of functional receptor
condition in neuromuscular synapses.
What transmitter will be blocked?
A. Acetylcholine
B. Noradrenalin
C. Dopamine
D. Serotonin
E. Glycine
174. Examination of a 35 year old patient
revealed high acidity of gastric juice. What
receptors should be blocked in order to
reduce it?
A. Histamine
B. α1 -adrenoreceptors
C. α2 -adrenoreceptors
D. β1 -adrenoreceptors
E. β2 -adrenoreceptors
175. Examination of a young woman
revealed a node-like, soft and elastic
homogenous tumour of pinkish-white
colour along the acoustic nerve. The
19
tumour contains cell bundles with oval
nuclei. Cellular fibrous bundles form
rhythmic structures made up by parallel
rows of regularly oriented cells arranged
in form of a palisade with cell-free
homogenous zone (Verocay bodies)
between them. What tumour is it?
A. Neurinoma
B. Malignant neurinoma
C. Ganglioneurinoma
D. Neuroblastoma
E. Ganglioneuroblastoma
176. A 45 year old woman is ill with
breast cancer. Her left arm has symptoms
of lymphatic system insufficiency - limb
edema, lymph node enlargement. What
form of lymphatic circulation insufficiency
is it?
A. Mechanic insufficiency
B. Dynamic insufficiency
C. Resorption insufficiency
D. Combined insufficiency
E. -
177. An endocrinal gland with
parenchyma consisting of epithelium
and neural tissue is under morphologi-
cal examination. Epithelial trabecules
have two types of cells: chromophilic and
chromophobic. Identify this organ:
A. Hypophysis
B. Adrenal glands
C. Hypothalamus
D. Thyroid gland
E. Parathyroid gland
178. While performing an inguinal canal
operation on account of hernia a surgeon
damaged the canal’s contents. What
exactly was damaged?
A. Funiculus spermaticus
B. Urarchus
C. Lig. teres uteri
D. Lig. inguinalе
E. -
179. A 12 year old child has intolerance
to some foodstuffs. Their consumption
causes an allergic reaction in form of itchi-
ng skin eruptions. What antihistaminic
drug should be admistered so that the chi-
ld could attend school?
 Krok 1 Medicine 2008
A. Loratadine
B. Dimedrol
C. Diclofenac
D. Aminophylline
E. Ephedrine
180. A patient that entered the admi-
ssion office had the following signs of
acute cardiac insufficiency: paleness,
acrocyanosis, frequent shallow respirati-
on. What drug is indicated in this case?
A. Corglycon
B. Digitoxin
C. Cordiamin
D. Nitroglycerine
E. Adrenaline hydrochloride
181. A 26 year old man is in the torpid
shock phase as a result of a car accident.
In blood: 3, 2 · 109 /l. What is the leading
mechanism of leukopenia development?
A. Redistribution of leukocytes in
bloodstream
B. Leikopoiesis inhibition
C. Disturbed going out of mature
leukocytes from the marrow into the
blood
D. Lysis of leukocytes in the blood-forming
organs
E. Intensified elimination of leukocytes
from the organism
182. A patient had hemorrhagic stroke.
Blood examination revealed strengthened
kinin concentration.The patient was
prescribed contrical. It was administered
in order to inhibit the following protei-
nase:
A. Kallikrein
B. Pepsin
C. Trypsin
D. Chemotrypsin
E. Collagenase
183. A patient with bacterial pneumonia
was prescribed benzylpenicillin. What is
the mechanism of its antibacterial effect?
A. Inhibition of synthesis of microorgani-
sm wall
B. Inhibition of intracellular protein
synthesis
C. Abnormal permeability of cytoplasmic
membrane
D. Inhibition of SH-groups of microorgani-
sm enzymes
E. Antagonism with p-amino-benzoic acid
184. Hartnup disease is caused by point
mutation of only one gene which results
20
in disturbance of tryptophane absorpti-
on in the bowels and its resorption in the
renal tubules. It is the reason for disorder
of both digestive and urination systems.
What genetic phenomenon is observed in
this case?
A. Pleiotropy
B. Complementary interaction
C. Polymery
D. Codominance
E. Semidominance
185. A patient who has been treated in
a neural clinic and has been taking a
sedative for a long time got the followi-
ng complication: cough, rhinitis, epiphora.
What drug caused these disturbances?
A. Sodium bromide
B. Diazepam
C. Valerian
D. Phenazepam
E. Reserpine
186. In order to accelerate healing of a
radiation ulcer a vitamin drug was admi-
nistered. What drug is it?
A. Retinol acetate
B. Retabolil
C. Prednisolone
D. Levamisole
E. Methyluracil
187. Inoculum from pharynx of a patient
ill with angina was inoculated into blood-
tellurite agar. It resulted in growth of
grey, radially striated (in form of rosettes)
colonies 4-5 mm in diameter. Gram-
positive bacilli with clublike thickenings
on their ends placed in form of spread wi-
de apart fingers are visible by microscope.
What microorganisms are these?
A. Diphtheria corynebacteria
B. Botulism clostridia
C. Diphtheroids
D. Streptococci
E. Streptobacilli
188. Plasmic factors of blood coagulation
are exposed to post-translational modifi-
cation with the participation of vitamin
K. It is necessary as a cofactor in the
enzyme system of γ-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?
 Krok 1 Medicine 2008
A. Glutamic
B. Valine
C. Serine
D. Phenylalanine
E. Arginine
189. Pharmacological effects of anti-
depressants are connected with inhibition
of an enzyme catalyzing biogenic amines
noradrenaline and serotonine in the mi-
tochondrions of cerebral neurons. What
enzyme participates in this process?
A. Monoamine oxidase
B. Transaminase
C. Decarboxylase
D. Peptidase
E. Lyase
190. An oncological patient was prescri-
bed methotrexate. With the lapse of time
target cells of the tumour lost susceptibi-
lity to this drug. There is change of gene
expression of the folowing enzyme:
A. Dehydrofolate reductase
B. Thiaminase
C. Deaminase
D. Folate oxidase
E. Folate decarboxylase
191. As a result of prophylactic medi-
cal examination a 7 year old boy was
diagnosed with Lesch-Nyhan syndrome
(only boys fall ill with it). The boy’s
parents are healthy but his grandfather
by his mother’s side suffers from the same
disease. What type of disease inheritance
is it?
A. Recessive, sex-linked
B. Dominant, sex-linked
C. Autosomal recessive
D. Autosomal dominant
E. Semidominance
192. Planned mass vaccination of all
newborn 5-7 day old children against
tuberulosis plays an important role in
tuberculosis prevention. In this case the
following vaccine is applied:
A. BCG
B. Diphteria and tetanus toxoids and
pertussis vaccine
C. Diphtheria and tetanus anatoxin vacci-
ne
D. Adsorbed diphtheria vaccine
E. -
193. A patient with hypertensic crisis was
admitted to the cardiological department,
he was injected intravenously with an anti-
21
hypertensive drug - salt of an alkaline-
earth metal. What drug was injected?
A. Magnesium sulfate
B. Potassium chloride
C. Sodium hydrocarbonate
D. Calcium lactate
E. Benzohexamethonium
194. In course of a small pelvis operation
it became necessary to ligate an ovari-
an artery. What formation may be acci-
dentally ligated together with it?
A. Ureter
B. Uterine tube
C. Round ligament of uterus
D. Internal iliac vein
E. Urethra
195. A patient with acute morphine poi-
soning was delivered to a hospital. What
specific narcotic antagonist should be
chosen in this case?
A. Naloxone
B. Paracetamol
C. Methacin
D. Digoxin
E. Unithiol
196. The upper lobe of the right lung
is enlarged, grey and airless, the inscisi-
on surface is dripping with turbid liquid,
the pleura has many fibrinogenous films;
microscopical examination of alveoles
revealed exudate containing neutrophi-
ls, desquamated alveolocytes and fibrin
fibers. The bronchus wall is intact. What is
the most probable diagnosis?
A. Croupous pneumonia
B. Interstitial pneumonia
C. Pulmonary abscess
D. Focal pneumonia
E. Influenzal pneumonia
197. A 28 year old patient had high
arterial pressure, hematuria and faci-
al edemata. In spite of treatment renal
insufficiency was progressing. 6 months
later the patient died from uremia. Mi-
croscopic examination of his kidneys and
their glomerules revealed proliferation of
capsule nephrothelium and of podocytes
with "demilune"formation, sclerosis and
hyalinosis of glomerules. What disease
corresponds with the described picture?
 Krok 1 Medicine 2008
A. Subacute glomerulonephritis
B. Acute pyelonephritis
C. Nephrotic syndrome
D. Chronic glomerulonephritis
E. Acute glomerulonephritis
198. A patient with a knife wound in
the left lumbal part was delivered to the
emergency hospital. In course of operati-
on a surgeon found that internal organs
were not damaged but the knife injured
one of muscles of renal pelvis. What
muscle is it?
A. Greater psoas muscle
B. Iliac muscle
C. Erector muscle of spine
D. Abdominal internal oblique muscle
E. Abdominal external oblique muscle
199. A man with a stab wound in the
area of quadrilateral foramen applied to
a doctor. Examination revealed that the
patient was unable to draw his arm asi-
22
de from his body. What nerve is most
probably damaged?
A. N.axillaris
B. N.medianus
C. N.radialis
D. N.ulnaris
E. N.subclavius
200. Autopsy of a man ill with severe
hypothyroidism revealed that connecti-
ve tissue, organ stroma, adipose and
cartilaginous tissues were swollen, semi-
transparent, mucus-like. Microscopic
examination of tissues revealed stellate
cells having processes with mucus
between them. What type of dystrophy
is it?
A. Stromal-vascular carbohydrate
B. Stromal-vascular adipose
C. Stromal-vascular proteinaceous
D. Parenchymatous proteinaceous
E. Parenchymatous adipose
 Krok 1 Medicine 2009
1. A 30-year-old patient complains
about having abdominal pain and di-
arrhea for five days; body temperature
rise up to 37, 5o C along with chills. The
day before a patient had been in a
forest and drunk from an open water
reservoir. Laboratory analyses enabled
to make the following diagnosis: amebic
dysentery. What is the drug of choice for
its treatment?
A. Metronidazole
B. Furazolidonum
C. Levomycetin
D. Phthalazol
E. Emetine hydrochloride
2. A man suffering from a hereditary di-
sease married a healthy woman. They got
5 children, three girls and two boys. All
the girls inherited their father’s disease.
What is the type of the disease inheri-
tance?
A. Dominant, X-linked
B. Autosomal recessive
C. Asutosomal dominant
D. Y -linked
E. Recessive, X-linked
3. An electronic microphotograph shows
a macrophagic cell with erythrocytes at
different stages of differentiation located
along its processes. This is the cell of the
following organ:
A. Red bone marrow
B. Thymus
C. Spleen
D. Tonsil
E. Lymph node
4. Quite often the cause of secondary
immunodeficiency is an infection
involvement, when the causative agents
propagate directly in the cells of immune
system and destroy it. The following di-
seases are characterized by:
A. Infectious mononucleosis, AIDS
B. Tuberculosis, mycobacteriosis
C. Poliomyelitis, type A hepatitis
D. Dysentery, cholera
E. Q-febris, epidemic typhus
5. Examination of a patient revealed a
dense, movable skin tumour that is standi-
ng out distinctly from the surrounding ti-
ssues. Its section is found to be white and
composed of fibrous tissue. Microscopic
examination revealed interlacing collagen
fibers and few cells. What tumour is it?
1
A. Fibroma
B. Myoma
C. Histiocytoma
D. Dermatofibroma
E. Desmoid
6. A patient underwent a surgery for exci-
sion of a cyst on pancreas. After this he
developed haemorrhagic syndrome with
apparent disorder of blood coagulation.
Development of this complication can be
explained by:
A. Activation of fibrinolytic system
B. Insufficient fibrin production
C. Reduced number of thrombocytes
D. Activation of anticoagulation system
E. Activation of Christmas factor
7. A mother consulted a doctor about her
5-year-old child who develops erythemas,
vesicular rash and skin itch under the
influence of sun. Laboratory studies
revealed decreased iron concentration in
the blood serum, increased uroporphyri-
nogen I excretion with the urine. What is
the most likely inherited pathology in this
child?
A. Erythropoietic porphyria
B. Methemoglobinemia
C. Hepatic porphyria
D. Coproporphyria
E. Intermittent porphyria
8. A baby refuses the breast, he is anxious,
presents with arrhythmic respiration. The
urine smells of "brewer’s yeast"or "maple
syrup". This pathology was caused by the
inherited defect of the following enzyme:
A. Dehydrogenase of branched-chain
alpha-keto acids
B. Glucose 6-phosphate dehydrogenase
C. Glycerol kinase
D. Aspartate aminotransferase
E. UDP-glucuronil transferase
9. While studying a microslide obtained
from the punctuate of a regional lymph
node and stained by Romanovsky-Giemsa
method a physician revealed some light-
pink thin microorganisms with 12-14
regular spiral coils and pointed ends, up
to 10-13 micrometer long. This might be
the causative agent of the following di-
sease:
 Krok 1 Medicine 2009
A. Syphilis
B. Trypanosomiasis
C. Leptospirosis
D. Relapsing fever
E. Leishmaniasis
10. Sanitary bacteriological research on
water by the membrane filter method
revealed two red colonies on a membrane
filter (Endo agar) through which 500 ml
of analyzed water were passed. Calculate
the coli index and coli titer of the analyzed
water:
A. 4 and 250
B. 2 and 500
C. 250 and 4
D. 500 and 2
E. 250 and 2
11. While examining a patient an
otolaryngologist noticed hyperaemia and
significantly edematous tonsils with a
grayish film upon them. Microscopical
examination of this film revealed some
gram-positive bacilli placed at an angle
with each other. What disease might be
suspected?
A. Diphtheria
B. Angina
C. Scarlet fever
D. Meningococcal nasopharyngitis
E. Epidemic parotitis
12. A 38-year-old patient with an uterine
haemorrhage lasting for 2 days was deli-
vered to the admission ward. Which of the
following will be revealed in the patient’s
blood?
A. Decrease in the haematocrite index
B. Eosinophilia
C. Deceleration in ESR
D. Leukocytosis
E. Increase in the colour index
13. After a hypertonic crisis a pati-
ent presents with lacking spontaneous
movements in his right arm and leg,
muscle tone of these extremities is
increased. What type of motor dysfuncti-
on has developed in this case?
A. Central paralysis
B. Peripheral paralysis
C. Peripheral paresis
D. Reflectrory paresis
E. Central paresis
14. A patient’s organism has decreased
concentration of magnesium ions that are
necessary for attachment of ribosomes
2
to the granular endoplasmatic reticulum.
It is known that this causes protein bi-
osynthesis disturbance. What stage of
protein biosynthesis will be disturbed?
A. Translation
B. Transcription
C. Replication
D. Amino acid activation
E. Termination
15. A patient suffering from stomach ulcer
has been treated with an antacid drug
almagel. For acute bronchitis treatment he
was prescribed the antibiotic methacycli-
ne. However within next 5 days the
fever didn’t fall, cough and sputum
nature remained unchanged. A physici-
an came to the conclusion that the drugs
were incompatible. What type of drug
incompatibility is the case?
A. Pharmacokinetic, absorption stage
B. Pharmacokinetic, biotransformation
stage
C. Pharmaceutic
D. Pharmacodynamic
E. Direct antagonism
16. A 70-year-old patient suffers from
atherosclerosis complicated by the lower
limb thrombosis that has caused gangrene
on his left toes. What is the most likely
cause of the thrombosis origin?
A. Thrombocyte adhesion
B. Prothrombinase activation
C. Transformation of prothrombin into
thrombin
D. Transformation of fibrinogen into fibrin
E. Impaired heparin synthesis
17. ECG of a 44-year-old patient shows
signs of hypertrophy of both ventricles
and the right atrium. The patient was di-
agnosed with the tricuspid valve insuffici-
ency. What pathogenetic variant of cardiac
dysfunction is usually observed in case of
such insufficiency?
A. Heart overload by volume
B. Heart overload by resistance
C. Primary myocardial insufficiency
D. Coronary insufficiency
E. Cardiac tamponade
18. Bacteriological examination of
purulent discharges from the urethra
revealed gram-negative bacteria looking
like coffee beans. They were localized
in the leukocytes and could decompose
glucose and maltose to acid. These are the
causative agents of the following disease:
 Krok 1 Medicine 2009
A. Gonorrhoea
B. Syphilis
C. Veneral lymphogranulomatosis
D. Soft chancre
E. Melioidosis
19. Proserin increases skeletal muscle tone
when given systematically. Halothane
induces relaxation of skeletal muscles
and reduces proserin effects. What is
the nature of proserin and halothane
interaction?
A. Indirect functional antagonism
B. Direct functional antagonism
C. Competitive antagonism
D. Independent antagonism
E. Noncompetitive antagonism
20. A 62-year-old female patient has
developed a cataract (lenticular opacity)
secondary to the diabetes mellitus. What
type of protein modification is observed
in case of diabetic cataract?
A. Glycosylation
B. Phosphorylation
C. ADP-ribosylation
D. Methylation
E. Limited proteolysis
21. Examination of a 2-year-old child
revealed physical developmental lag, the
child often has pneumonias. The child
was diagnosed with nonclosure of ductus
arteriosus. Haemodynamics disorder was
caused by the intercommunication of the
following vessels:
A. Aorta and pulmonary trunk
B. Pulmonary trunk and pulmonary veins
C. Superior cava and aorta
D. Superior cava and pulmonary trunk
E. Aorta and pulmonary veins
22. The temperature of the ambient envi-
ronment is 38o C and relative air humidity
is 50%. What ways of heat emission provi-
de maintaining a constant temperature of
the human body?
A. Evaporation
B. Radiation
C. Heat conduction
D. Convection
E. Convection and conduction
23. A married couple consulted a speci-
alist at the genetic consultation about
probability of having children with
hemophilia. Both spouses are healthy, but
the wife’s father has hemophilia. In this
3
family hemophilia may be passed to:
A. Half of sons
B. Both sons and daughters
C. Daughters only
D. Half of daughters
E. All the children
24. The minute blood volume in a patient
with transplanted heart has increased as a
result of physical activity. What regulati-
ve mechanism is responsible for these
changes?
A. Catecholamines
B. Sympathetic unconditioned reflexes
C. Parasympathetic unconditioned reflexes
D. Sympathetic conditioned reflexes
E. Parasympathetic conditioned reflexes
25. A female patient consulted a
physician about digestive disorder,
extended abdominal pain. Examination
revealed drastic decrease in hemoglobin
concentration. It is known from the
anamnesis that while living in the Far East
the patient used to eat freshly-salted cavi-
ar. Some relatives living with her had the
similar condition. What is the most likely
diagnosis?
A. Diphyllobothriasis
B. Echinococcosis
C. Teniasis
D. Trichiniasis
E. Ascaridiasis
26. A man has normal sensitivity of his fi-
nger skin, however he doesn’t sense his
wedding ring around the finger. What
process induced by wearing of the ring
has caused this phenomenon?
A. Receptor adaptation
B. Development of the fibrous tissue
C. Abnormality of the epidermis structure
D. Impaired circulation
E. Abnormality of the receptor structure
27. It is necessary to take the cerebrospi-
nal fluid from a patient with suspected
inflammation of brain tunics. Diagnostic
puncture was performed between the
arches of the lumbar vertebras. During
the puncture the needle went through the
following ligament:
A. Yellow (flaval)
B. Iliolumbar
C. Anterior longitudinal
D. Posterior longitudinal
E. Intertransverse
 Krok 1 Medicine 2009
28. ECG study showed that the T -waves
were positive in the standard extremity
leads, their amplitude and duration were
normal. The right conclusion would be
that the following process runs normally
in the heart ventricles:
A. Repolarization
B. Depolarization
C. Excitement
D. Contraction
E. Relaxation
29. A patient has an increased pyruvate
concentration in blood. A large amount
of it is excreted with the urine. What vi-
tamin is lacking in this patient?
A. B1
B. E
C. B3
D. B6
E. B2
30. A patient has pellagra. Interrogation
revealed that he had lived mostly on mai-
ze for a long time and eaten little meat.
This disease had been caused by the defi-
cit of the following substance in the maize:
A. Tryptophan
B. Tyrosine
C. Proline
D. Alanine
E. Histidine
31. Study of bacteriological sputum speci-
mens stained by the Ziel-Neelsen method
revealed some bright-red acid-resistant
bacilli that were found in groups or si-
ngularly. When inoculated onto the nutri-
ent media, the signs of their growth show
up on the 10-15 day. These bacteria relate
to the following family:
A. Micobacterium tuberculosis
B. Yersinia pseudotuberculosis
C. Histoplasma dubrosii
D. Klebsiella rhinoscleromatis
E. Coxiella burnettii
32. A patient with high rate of obesity was
advised to use carnitine as a food additive
in order to enhance "fat burning". What
is the role of carnitine in the process of fat
oxidation?
4
A. Transport of FFA (free fatty acids) from
cytosol to the mitochondria
B. Transport of FFA from fat depots to the
tissues
C. It takes part in one of reactions of FFA
beta-oxidation
D. FFA activation
E. Activation of intracellular lipolysis
33. In a 2-year-old child with catarrhal
presentations and skin rash a pediatri-
cian suspected scarlet fever. The child
was given intracutaneously a small dose
of serum antibody to the streptococcal
erythrogenic toxin; on the site of injection
the rash disappeared. What do the reacti-
on results mean?
A. The clinical diagnosis was confirmed
B. The child has hypersensitivity to the
erythrogenic toxin
C. The disease wasn’t caused by haemolytic
streptococcus
D. The whole serum dose may be injected
intravenously
E. The child has very weak immune system
34. A patient has a transversal lacerati-
on in the spinal cord. What respiratory
changes will result from this?
A. Respiration will present no significant
changes
B. Respiration will stop
C. Respiration will become less frequent
D. Respiration will become deeper
E. Respiration will become more frequent
35. A female patient suffering from
bronchial asthma had got a viral infecti-
on that provoked status asthmaticus wi-
th fatal outcome. Histological examinati-
on of lungs revealed spasm and edema of
bronchioles, apparent infiltration of their
walls with lymphocytes, eosinophils and
other leukocytes; labrocyte degranulati-
on. What mechanism of hypersensitivity
underlies the described alterations?
A. Reagin reaction
B. Inflammatory
C. Autoimmune
D. Immune complex
E. Immune cytolysis
36. In the perianal folds of a 5-year-old
girl her mother has found some white
"worms"that caused itch and anxiety in
the child. The "worms"were sent to the
laboratory. During examination the physi-
cian saw white filiform helminths 0,5-1 cm
long, with pointed ends, some helminths
had twisted ends. What is the most likely
 Krok 1 Medicine 2009
diagnosis?
A. Enterobiasis
B. Diphyllobothriasis
C. Teniasis
D. Ascaridiasis
E. Opisthorchiasis
37. Examination of a 27-year-old patient
revealed pathological changes in liver and
brain. Blood plasma analysis revealed an
abrupt decrease in the copper concentrati-
on, urine analysis revealed an increased
copper concentration. The patient was di-
agnosed with Wilson’s degeneration. To
confirm the diagnosis it is necessary to
study the activity of the following enzyme
in blood serum:
A. Ceruloplasmin
B. Carbonic anhydrase
C. Xanthine oxidase
D. Leucine aminopeptidase
E. Alcohol dehydrogenase
38. A patient complains about dyspnea
provoked by the physical activity. Clini-
cal examination revealed 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 the pati-
ent’s urine:
A. Bence Jones protein
B. Bilirubin
C. Haemoglobin
D. Ceruloplasmin
E. Antitrypsin
39. After a serious psycho-emotional
stress a 45-year-old patient suddenly felt
constricting heart pain irradiating to the
left arm, neck and left scapula. His face
turned pale, the cold sweat stood out on
it. The pain attack was stopped with ni-
troglycerine. What process has developed
in this patient?
A. Stenocardia
B. Myocardial infarction
C. Stroke
D. Psychogenic shock
E. Stomach ulcer perforation
40. A 62-year-old female patient complai-
ns about frequent pains in the region of
thorax and vertebral column, rib fractures.
A physician suspected myelomatosis
(plasmocytoma). Which of the following
laboratory indices will be of the greatest
diagnostic importance?
5
A. Paraproteinemia
B. Hyperalbuminemia
C. Proteinuria
D. Hypoglobulinemia
E. Hypoproteinemia
41. An 8-year-old child was admitted
to the infectious department with fever
(up to 38o C) and punctuate bright-red
skin rash. The child was diagnosed as
having scarlet fever. Objectively: mucous
membrane of pharynx is apparently
hyperaemic and edematic, the tonsils are
enlarged and have dull yellowish-grey foci
with some black areas. What inflammati-
on is the reason for the pharynx alterati-
ons?
A. Purulent necrotic
B. Fibrinous
C. Haemorrhagic
D. Serous
E. Catarrhal
42. Nappies of a newborn have dark spots
being the evidence of homogentisic acid
formation. This is caused by the metabolic
disorder of the following substance:
A. Tyrosine
B. Galactose
C. Methionine
D. Cholesterol
E. Tryptophan
43. A histological specimen presents a
receptor zone of a sensoepithelial sense
organ. Cells of this zone are placed upon
the basal membrane and include the
following types: external and internal
receptor cells, external and internal
phalangeal cell, stem cells, external limiti-
ng cells and external supporting cell. The
described receptor zone belongs to the
following sense organ:
A. Acoustic organ
B. Visual organ
C. Gustatory organ
D. Equilibrium organ
E. Olfactory organ
44. A patient was admitted to the hospi-
tal with an asphyxia attack provoked
by a spasm of smooth muscles of the
respiratory tracts. This attack was mai-
nly caused by alterations in the following
parts of the airways:
 Krok 1 Medicine 2009
A. Small bronchi
B. Median bronchi
C. Large bronchi
D. Terminal bronchioles
E. Respiratory part
45. While eating a child choked on
food and aspirated it. The child has
severe cough, cyanotic skin and mucous
membranes, rapid pulse, infrequent respi-
ration, prolonged expiration. The child
has developed the following disorder of
the external respiration:
A. Expiratory dyspnea under asphyxia
B. Inspiratory dyspnea under asphyxia
C. Stenotic respiration
D. Alternating respiration
E. Biot’s respiration
46. A 50-year-old patient complains
about general weakness, appetite loss
and cardiac arrhythmia. The patient
presents with muscle hypotonia, flaccid
paralyses, weakened peristaltic activity
of the bowels. Such condition might be
caused by:
A. Hypokaliemia
B. Hypoproteinemia
C. Hyperkaliemia
D. Hypophosphatemia
E. Hyponatremia
47. While playing volleyball a sportsman
jumped and then landed across the
external edge of his foot. This caused
acute pain in the talocrural articulation,
active movements became limited, passive
movements remained unlimited but pai-
nful. In the region of the external ankle
a swelling appeared, the skin turned red
and became warmer to the touch. What
type of peripheral circulation disorder has
developed in this case?
A. Arterial hyperaemia
B. Stasis
C. Embolism
D. Venous hyperaemia
E. Thrombosis
48. A patient suffering from myasthenia
has been administered proserin. After its
administration the patient has got nausea,
diarrhea, twitch of tongue and skeletal
muscles. What drug would help to elimi-
nate the intoxication?
6
A. Atropine sulfate
B. Physostigmine
C. Pyridostigmine bromide
D. Isadrine
E. Mesatonum
49. A man died from an acute infecti-
ous disease accompanied by fever, jaundi-
ce, haemorrhagic rash on the skin
and mucous membranes as well as by
acute renal insufficiency. Histological
examination of renal tissue (stained by
Romanovsky-Giemsa method) revealed
some convoluted bacteria looking like
C und S letters. What bacteria were
revealed?
A. Leptospira
B. Treponema
C. Spirilla
D. Borrelia
E. Campilobacteria
50. A 12-year-old adolescent suffering
from bronchial asthma has a severe attack
of asthma: he presents with marked expi-
ratory dyspnea, skin pallor. What type of
alveolar ventilation disorder is observed?
A. Obstructive
B. Restrictive
C. Thoracodiaphragmatic
D. Central
E. Neuromuscular
51. A 46-year-old patient suffering from
the diffuse toxic goiter underwent resecti-
on 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?
A. Reduced production of parathormone
B. Increased production of thyroxin
C. Increased production of calcitonin
D. Increased production of thyroliberin
E. Reduced production of thyroxin
52. A patient who had myocardial infarcti-
on was administered 75 mg of acetylsalici-
nic acid a day. What is the purpose of this
administration?
A. Reduction of thrombocyte aggregation
B. Inflammation reduction
C. Pain relief
D. Temperature reduction
E. Coronary vessel dilatation
53. Medical examination at the mili-
 Krok 1 Medicine 2009
tary registration and enlistment office
revealed that a 15-year-old boy was hi-
gh, with eunuchoid body proportions,
gynecomastia, female pattern of pubic
hair distribution. The boy had also fat
deposits on the thighs, no facial hair, hi-
gh voice, subnormal intelligence quotient.
Which karyotype corresponds with this di-
sease?
A. 47, XXY
B. 45, XO
C. 46, XX
D. 46, XY
E. 47, XXX
54. To prevent the transplant rejection
after organ transplantation it is requi-
red to administer hormonotherapy for
the purpose of immunosuppression. What
hormones are used for this purpose?
A. Glucocorticoids
B. Mineralocorticoids
C. Sexual hormones
D. Catecholamines
E. Thyroid
55. A 53-year-old female patient was di-
agnosed with liver rupture resulting from
a blunt abdominal injury. The escaped
blood will be assembled in the followi-
ng anatomic formation:
A. Rectouterine pouch
B. Vesicouterine pouch
C. Right mesenteric sinus
D. Omental bursa
E. Left mesenteric sinus
56. A patient complains about edemata
of legs, skin cyanosis, small ulcers on
one side of the lateral condyle. Exami-
nation revealed a swelling, enlarged vei-
ns, formation of nodes. The pathological
process has started in the following vein:
A. V. saphena parva
B. V. saphena magna
C. V. femoralis
D. V. profunda femoris
E. V. iliaca externa
57. A 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 of trichloroacetic iron had
been added to the child’s urine it turned
olive green. Such alteration are typical for
the following pathology of the amino acid
metabolism:
7
A. Phenylketonuria
B. Alkaptonuria
C. Tyrosinosis
D. Albinism
E. Xanthinuria
58. Autopsy of a 73-year-old man who had
been suffering from the coronary heart di-
sease along with cardiac insufficiency for
a long time revealed: nutmeg liver, brown
induration of lungs, cyanotic induration
of kidneys and spleen. What kind of ci-
rculation disorder was the cause of such
effects?
A. General chronic venous congestion
B. Arterial hyperaemia
C. General acute venous congestion
D. Acute anaemia
E. Chronic anaemia
59. A patient suffering from chronic
hyperacidic gastritis takes an antacid
drug for heartburn elimination. After its
ingestion the patient feels better but at the
same time he has a sensation of stomach
swelling. Which of the following drugs mi-
ght be the cause of such side effect?
A. Sodium hydrocarbonate
B. Magnesium oxide
C. Magnesium trisilicate
D. Aluminium hydrooxide
E. Pepsin
60. Continuous use of a certain drug may
cause osteoporosis, erosions of stomach
mucosa, hypokaliemia, retention of sodi-
um and water in the organism, decreased
concentration of corticotropin in blood.
What drug is it?
A. Prednisolone
B. Hypothiazide
C. Digoxin
D. Indometacin
E. Reserpine
61. 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?
A. Fascial
B. Glomerular
C. Reticular
D. Glomerular and reticular
E. -
62. A 63-year-old patient with collapse
presentations was delivered to the
emergency hospital. A physician has
chosen noradrenalin against hypotension.
 Krok 1 Medicine 2009
What is its mechanism of action?
A. Activation of α1 -adrenoreceptors
B. Activation of serotonin receptors
C. Activation of β-adrenoreceptors
D. Activation of dopamine receptors
E. Block of M-cholinoreceptors
63. The greater amount of nitrogen is
excreted from the organism in form of
urea. Inhibition of urea synthesis and
accumulation of ammonia in blood and
tissues are induced by the decreased acti-
vity of the following liver enzyme:
A. Carbamoyl phosphate synthetase
B. Aspartate aminotransferase
C. Urease
D. Amylase
E. Pepsin
64. A patient suffering from syphilis has
been treated with bismuth preparations.
As a result of it some grey spots turned
up on the mucous membrane of the oral
cavity; nephropathy symptoms were also
present. What drug should be used for
treatment of bismuth intoxication?
A. Unithiol
B. Methylene blue
C. Naloxone
D. Bemegride
E. Nalorphine
65. ECG of a patient shows such alterati-
ons: P -wave is normal, P − Q-interval is
short, ventricular QRST complex is wi-
de, R-wave is double-peak or two-phase.
What form of arrhythmia is it?
A. WPW syndrome (Wolff-Parkinson-
White)
B. Frederick’s syndrome (atrial flutter)
C. Atrioventricular block
D. Ventricular fibrillation
E. Ciliary arrhythmia
66. In a histological specimen parenchyma
of an organ is represented by lymphoid ti-
ssue that forms lymph nodes; the latter are
arranged in a diffuse manner and enclose
a central artery. What anatomic formation
has such morphological structure?
A. Spleen
B. Tonsil
C. Lymph node
D. Thymus
E. Red bone marrow
67. Examination of a patient with frequent
haemorrhages from the internal organs
8
and mucous membranes revealed proline
and lysine within the collagen fibers. Di-
sorder of their hydroxylation is caused by
lack of the following vitamin:
A. Vitamin C
B. Vitamin K
C. Vitamin A
D. Vitamin B1
E. Vitamin E
68. During a prophylactic medical exami-
nation a 7-year-old boy was diagnosed
with daltonism. His parents are healthy
and have normal colour vision, but his
grandfather on his mother’s side has the
same abnormality. What is the type of the
abnormality inheritance?
A. Recessive, sex-linked
B. Dominant, sex-linked
C. Semidominance
D. Autosomal recessive
E. Autosomal dominant
69. In a healthy adult speed of the
excitement conduction through the atri-
oventricular node is 0,02-0,05 m/sec. Atri-
oventricular delay enables:
A. Sequence of atrial and ventricular
contractions
B. Simultaneity of both atria contractions
C. Simultaneity of both ventricles
contractions
D. Sufficient force of atrial contractions
E. Sufficient force of ventricular contracti-
ons
70. A histological specimen of a kidney
shows a part of the distal tubule going
between the afferent and efferent arteri-
ole. The cells building the tubule wall have
dense nuclei; basal membrane is absent.
Such structural formation is called:
A. Macula densa
B. Juxtaglomerular cells
C. Mesangial cells
D. Juxtavascular cells
E. -
71. Stimulation of an excitable cell by the
electric current has led to the depolarizati-
on of its membrane. The depolarization
has been caused mainly by the following
ions penetrating into the cell through its
membrane:
 Krok 1 Medicine 2009
A. Na+
B. HCO 3−
C. Ca2+
D. Cl−
E. K +
72. Products of some proteins hydrolysis
and modification are the biologically
active substances called hormones. Li-
potropin, corticotropin, melanotropin
and endorphins are synthesized in the
hypophysis of the following protein:
A. Proopiomelanocortin (POMC)
B. Neuroalbumin
C. Neurostromin
D. Neuroglobulin
E. Thyreoglobulin
73. In 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. K
B. A
C. D
D. E
E. C
74. A 48-year-old patient was admitted
to the hospital with complaints about
weakness, irritability, sleep disturbance.
Objectively: skin and scleras are of yellow
colour. In blood: increased concentration
of total bilirubin with prevailing direct bi-
lirubin. The feces are acholic. The urine is
dark (contains bile pigments). What type
of jaundice is it?
A. Mechanic
B. Haemolytic
C. Parenchymatous
D. Gilbert’s syndrome
E. Crigler-Najjar syndrome
75. A bacteriological laboratory has recei-
ved smears from the sputum of a pati-
ent with a chronic pulmonary disease.
Microscopical examination of the smears
stained by the Ziehl-Neelsen technique
revealed red bacilli. What property of the
tuberculosis bacillus has shown itself?
A. Acid resistance
B. Alkali resistance
C. Alcohol resistance
D. Capsule formation
E. Spore formation
76. Microscopical examination of an
enlarged cervical lymph node revealed
9
blurring of its structure, absence of
lymphoid follicles; all the microscopic fi-
elds showed cells with roundish nuclei and
thin limbus of basophil cytoplasm. It is
known from the clinical data that other
groups of lymph nodes are also enlarged
as well as spleen and liver. What disease
might be suspected?
A. Lymphoid leukosis
B. Lymphogranulomatosis
C. Lymphosarcoma
D. Myeloid leukosis
E. Multiple myeloma
77. Two weeks after lacunar tonsillitis a 20-
year-old man started complaining about
general weakness, lower eyelid edemata.
After examination the patient was di-
agnosed with acute glomerulonephritis.
What are the most likely pathological
changes in the urine formula?
A. Proteinuria
B. Cylindruria
C. Presence of fresh erythrocytes
D. Pyuria
E. Natriuria
78. A 38-year-old patient came to a
traumatology centre and complained
about an injury of his right hand. Objecti-
vely: the patient has a cut wound in the
region of the thenar eminence on the right
hand; distal phalanx of the I finger cannot
be flexed. What muscle was injured?
A. Long flexor muscle of thumb
B. Short flexor muscle of thumb
C. Short abductor muscle of thumb
D. Opposer muscle of thumb
E. Abductor muscle of thumb
79. Lung ventilation in a person is
increased as a result of physical activi-
ty. Which of the following indices of the
external respiration is much higher than
in a state of rest?
A. Respiratory volume
B. Vital capacity of lungs
C. Inspiratory reserve volume
D. Expiratory reserve volume
E. Total lung capacity
80. As a result of continuous starvati-
on the glomerular filtration rate has
increased by 20%. The most probable
cause of the glomerular filtration alterati-
on under the mentioned conditions is:
 Krok 1 Medicine 2009
A. Decrease in the oncotic pressure of
blood plasma
B. Increase in the systemic arterial pressure
C. Increase in the permeability of the renal
filter
D. Increase of the filtartion quotient
E. Increase of the renal blood flow
81. After transfusion of 200 ml of blood a
patient presented with body temperature
rise up to 37, 9o C. Which of the followi-
ng substances is the most likely cause of
temperature rise?
A. Interleukin-1
B. Interleukin-2
C. Tumour necrosis factor
D. Interleukin-3
E. Interleukin-4
82. A man who is riding the carousel
presents with increased heart rate, sweati-
ng, nausea. This condition is caused pri-
marily by the stimulation of the following
receptors:
A. Vestibular ampullar
B. Proprioceptors
C. Vestibular otolithic
D. Auditory
E. Visual
83. A worker of a cattle farm fell acutely
ill and then died from the progressing
intoxication. Autopsy revealed enlarged,
hyposthenic spleen of dark-cherry colour
when dissected; excessive pulp scraping.
At the base and fornix of brain pia maters
are edematous, soaked with blood, dark-
red ("scarlet hat"). Microscopic exami-
nation revealed serous haemorrhagic
inflammation of brain tissues and tuni-
cs along with destruction of small vessel
walls. What is the most likely diagnosis?
A. Anthrax
B. Tularemia
C. Brucellosis
D. Plaque
E. Cholera
84. A 49-year-old patient consulted a
doctor about increased fatigability and
dyspnea provoked by physical activity.
ECG results: heart rate - 50/min, P Q-
interval is prolonged, QRS- complex
is unchanged, the number of P -waves
exceeds the number of QRS-complexes.
What type of arrhythmia is it?
10
A. Atrioventricular block
B. Extrasystole
C. Sinus bradycardia
D. Ciliary arrhythmia
E. Sinoatrial block
85. A patient suffering from coronary
artery disease had taken a certain
drug many times a day in order to
arrest stenocardia attacks. Overdose of
this drug finally caused intoxication.
Objectively: cyanotic skin and mucous
membranes, dramatic fall in the arterial
pressure, tachycardia, respiration inhibiti-
on. Blood has increased concentration of
methemoglobin. The drug the patient had
taken relates to the following group:
A. Organic nitrates
B. α-adrenoceptor blockers
C. Calcium channel blockers
D. Adenosine drugs
E. Myotropic spamolytics
86. A patient with android-type obesi-
ty had been suffering from arterial
hypertension, hyperglycemia, glycosuria
for a long time and died from the cerebral
haemorrhage. Pathologic examination
revealed pituitary basophil adenoma,
adrenal cortex hyperplasia. What is the
most likely diagnosis?
A. Itsenko-Cushing’s syndrome
B. Diabetes mellitus
C. Acromegalia
D. Pituitary nanism
E. Adiposogenital dystrophy
87. A middle-aged man went to a foreign
country because he had been offered a job
there. However he had been unemployed
for quite a long time. What endocrine
glands were exhausted most of all in this
man?
A. Adrenal glands
B. Parathyroid glands
C. Seminal glands
D. Substernal gland
E. Thyroid gland
88. A girl has been diagnosed with
adrenogenital syndrome (pseudohermaphrodi-
tism). This pathology is caused by
hypersecretion of the following adrenal
hormone:
 Krok 1 Medicine 2009
A. Androgens
B. Estrogens
C. Mineralocorticoids
D. Glucocorticoids
E. Catecholamines
89. A woman delivered a dead child wi-
th multiple developmental defects. What
protozoan disease might have caused the
intrauterine death?
A. Toxoplasmosis
B. Leishmaniasis
C. Malaria
D. Amebiasis
E. Lambliasis
90. A patient has a massive haemorrhage
caused by damage of the dorsal li-
ngual artery by cancer of tongue back.
What vessel should be ligated for the
haemorrhage arrest?
A. Lingual artery
B. Dorsal lingual artery
C. Deep artery of tongue
D. Facial artery
E. Ascending pharyngeal artery
91. A 12-year-old teenager has signifi-
cantly put off weight within 3 months;
glucose concentration rose up to 50 mi-
llimoleł. He fell into a coma. What is the
main mechanism of its development?
A. Hyperosmolar
B. Hypoglycemic
C. Ketonemic
D. Lactacidemic
E. Hypoxic
92. As a result of increased permeabi-
lity of the erythrocyte membrane
in a patient with microspherocytic
anaemia (Minkowsky-Shauffard disease)
cells receive sodium ions and water.
Erythrocytes take form of spherocytes
and can be easily broken down. What
is the leading mechanism of erythrocyte
damage in this case?
A. Electrolytic osmotic
B. Calcium
C. Acidotic
D. Protein
E. Nucleic
93. A histological specimen shows a
blood vessel. Its inner coat is composed
by endothelium, subendothelium and
internal elastic membrane. The middle
coat is enriched with smooth myocytes.
Such morphological characteristics are
11
typical for the following vessel:
A. Muscular-type artery
B. Elastic-type artery
C. Capillary
D. Non-muscular vein
E. Muscular-type vein
94. Cooling of the human body in water is
much more faster than in the air. What
way of heat emission in water is much
more effective?
A. Heat conduction
B. Convection
C. Heat radiation
D. Sweat evaporation
E. -
95. An 18-year-old man was delivered to
the hospital after a road accident. Exami-
nation at the traumatological department
revealed multiple injuries of soft tissues of
face in the region of the medial eye angle.
The injuries caused massive haemorrhage.
What arterial anastomosis might have
been damaged in this region?
A. a. carotis externa et a. carotis interna
B. a. carotis externa et a. subclavia
C. a. carotis interna et a. subclavia
D. a. subclavia et a. ophthalmica
E. a. carotis interna et a. ophthalmica
96. After a surgery a 36-year-old woman
was given an intravenous injection of
concentrated albumin solution. This has
induced intensified water movement in
the following direction:
A. From the intercellular fluid to the
capillaries
B. From the intercellular fluid to the cells
C. From the cells to the intercellular fluid
D. From the capillaries to the intercellular
fluid
E. No changes of water movement will be
observed
97. Autopsy of a man with a mali-
gnant stomach tumour who had di-
ed from cancer intoxication revealed
in the posteroinferior lung fields some
dense, grayish-red irregular foci protrudi-
ng above the section surface. Microscopic
examination revealed exudate containi-
ng a large amount of neutrophils in the
lumen and walls of small bronchi and
alveoles. Such pulmonary alterations indi-
cate the following disease:
 Krok 1 Medicine 2009
A. Acute purulent bronchopneumonia
B. Acute bronchitis
C. Croupous pneumonia
D. Intermittent pneumonia
E. Acute serous bronchopneumonia
98. Autopsy of a 1,5-year-old chi-
ld revealed haemorrhagic skin rash,
moderate hyperaemia and edema of
nasopharyngeal mucous membrane, small
haemorrhages in the mucous membranes
and internal organs; dramatic dystrophic
alterations in liver and myocardium; acute
necrotic nephrosis; massive haemorrhages
in the adrenal glands. What disease are
these alterations the most typical for?
A. Meningococcal infection
B. Scarlet fever
C. Diphtheria
D. Measles
E. Epidemic typhus
99. During examination of an 11-
month-old infant a pediatrician revealed
osteoectasia of the lower extremities and
delayed mineralization of cranial bones.
Such pathology is usually provoked by the
deficit of the following vitamin:
A. Cholecalciferol
B. Thiamin
C. Pantothenic acid
D. Bioflavonoids
E. Riboflavin
100. Examination of a patient suffering
from chronic hepatitis revealed a signifi-
cant decrease in the synthesis and secreti-
on of bile acids. What process will be mai-
nly disturbed in the patient’s bowels?
A. Fat emulsification
B. Protein digestion
C. Carbohydrate digestion
D. Glycerin absorption
E. Amino acid absorption
101. Retrospective diagnostics of bacterial
dysentery involved serological analysis of
blood serum intended for determination
of Shigella antibody titre. Which of the
following reactions should be applied for
this purpose?
A. Passive haemagglutination
B. Complement binding
C. Precipitation
D. Haemolysis
E. Bacteriolysis
102. You are studying functioning of
a bacteria operon. The operator gene
12
has been released from the repressor
gene. Immediately after this the followi-
ng process will start in the cell:
A. Transcription
B. Translation
C. Replication
D. Processing
E. Repression
103. While determining power inputs of a
patient’s organism it was established that
the respiratory coefficient equaled 1,0.
This means that in the cells of the pati-
ent the following substances are mainly
oxidized:
A. Carbohydrates
B. Proteins
C. Fats
D. Proteins and carbohydrates
E. Carbohydrates and fats
104. During an experiment the dorsal
roots of the spinal cord of an animal have
been cut. What changes will be observed
in the innervation zone?
A. Sensitivity loss
B. Loss of motor functions
C. Decrease in muscle tone
D. Increase in muscle tone
E. Sensitivity loss and loss of motor functi-
ons
105. An experimental animal has lost ori-
entative reflexes as a result of destructi-
on of certain brainstem structures. What
structures had been destroyed?
A. Quadrigeminal plate
B. Medial nuclei of the reticular formation
C. Red nuclei
D. Vestibular nuclei
E. Black substance
106. A patient has osmotic pressure of
blood plasma at the rate of 350 mOsmol/l
(norm is 300 mOsmol/l). This will cause
hypersecretion of the following hormone:
A. Vasopressin
B. Aldosterone
C. Cortisol
D. Adrenocorticotropin
E. Natriuretic
107. After a sprint an untrained person
develops muscle hypoxia. This leads to the
accumulation of the following metabolite
in muscles:
 Krok 1 Medicine 2009
A. Lactate
B. Ketone bodies
C. Acetyl CoA
D. Glucose 6-phosphate
E. Oxaloacetate
108. Cytoplasm of the myocytes contains a
lot of dissolved metabolites resulting from
glucose oxidation. Name the metabolite
that turns directly into lactate:
A. Pyruvate
B. Oxaloacetate
C. Glycerophosphate
D. Glucose-6-phosphate
E. Fructose-6-phosphate
109. A young man complains about
urination disorder. Examination of the
external genitals revealed that the urethra
was split and urine could flow out of this
orifice. What anomaly of the external
genitals development is it?
A. Epispadia
B. Phimosis
C. Hermaphroditism
D. Paraphimosis
E. Hypospadia
110. A patient consulted an urologist
about pain during urination. Analysis of
his urine taken in the daytime revealed
eggs with a characteristic sharp point. It is
known from the anamnesis that the pati-
ent has recently returned from Australia.
What is the most likely diagnosis?
A. Urogenital schistosomiasis
B. Intestinal schistosomiasis
C. Japanese schistosomiasis
D. Opisthorchiasis
E. Dicroceliasis
111. Colonoscopy of a patient with
dysentery revealed that the mucous
membrane of the large intestine was
hyperemic, edematic, and its surface was
covered with grey-and-green layerings.
What morphological form of dysenteric
colitis is it?
A. Fibrinous
B. Catarrhal
C. Ulcerous
D. Purulent
E. Necrotic
112. Examination of a patient 24 hours
after appendectomy revealed neutrophi-
lic leukocytosis with a regenerative shi-
ft. What is the most likely mechanism of
leukocytosis development?
13
A. Intensification of leukopoiesis
B. Redistribution of the leukocytes in the
organism
C. Deceleration of leukocyte breakdown
D. Deceleration of leukocyte migration to
the tissues
E. Intensification of leukopoiesis and
deceleration of leukocyte migration to the
tissues
113. A 35-year-old patient complains
about having severe rhinitis and loss of
sense of smell for a week. Objectively: the
nasal cavity contains a lot of mucus coveri-
ng the mucous membrane and blocking
olfactory receptors. In what region of the
nasal cavity are these receptors located?
A. Superior nasal concha
B. Median nasal concha
C. Inferior nasal concha
D. Common nasal meatus
E. Vestibule of nose
114. A 10-year-old child had the mantoux
tuberculin test administered. 48 hours
later a papule up to 8 mm in diameter
appeared on the site of the injection.
What type of hypersensitivity reaction
developed after the tuberculin injection?
A. Type IV hypersensitivity reaction
B. Arthus phenomenon
C. Seroreaction
D. Atopic reaction
E. Type II hypersensitivity reaction
115. Vitamin B1 deficiency causes di-
sturbance of oxidative decarboxylati-
on of α-ketoglutaric acid. This leads to
the impaired synthesis of the following
coenzyme:
A. Thiamine pyrophosphate
B. Nicotinamide adenine dinucleotide
C. Flavine adenine dinucleotide
D. Lipoic acid
E. Coenzyme A
116. On the ground of clinical presentati-
ons a patient was prescribed pyri-
doxal phosphate. This medication is
recommended for correction of the
following processes:
A. Transamination and decarboxylation of
amino acids
B. Oxidative decarboxylation of ketonic
acids
C. Desamination of purine nucleotides
D. Synthesis of purine and pyrimidin bases
E. Protein synthesis
 Krok 1 Medicine 2009
117. A patient with clinical presentati-
ons of immunodeficiency has undergone
immunological tests. They revealed signi-
ficant decrease in number of cells that
form rosettes with sheep erythrocytes.
What conclusion can be drown on the
ground of the analysis data?
A. Decrease in T -lymphocyte level
B. Decrease in B-lymphocyte level
C. Decrease in natural killer level (NK-
cells)
D. Decrease in complement system level
E. Lack of effector cells of the humoral
immunity
118. A man had worked in a coal mi-
ne for over 20 years. After his death
autopsy revealed that his lungs were
dense, grayish-black and had large areas
of neogenic connective tissue containing
a lot of microphages with black pigment
in the cytoplasm. What is the most likely
diagnosis?
A. Anthracosis
B. Anthracosilicosis
C. Silicoanthracosis
D. Talcosis
E. Siderosis
119. Autopsy of a man who died
from sepsis revealed a phlegmonous
inflammation in the femoral bone of lower
extremity. The inflammation was seen
in the bone marrow, haversian canals
and periosteum. There were also multi-
ple abscesses underneath the periosteum;
the surrounding soft tissues of the thigh
were also affected by the phlegmonous
inflammation. What pathological process
is it?
A. Acute haematogenous osteomyelitis
B. Osteoporosis
C. Chronic haematogenous osteomyelitis
D. Osteopetrosis
E. -
120. After the prior sensibilization
an experimental animal was given a
subcutaneous injection of an antigen.
The place of injection exhibited a fi-
brinous inflammation with alteration of
the vessel walls, basal substance and fi-
brous structures of the connective tissue
in form of mucoid and fibrinoid swelling
and necrosis. What immunological reacti-
on is it?
14
A. Immediate hypersensitivity
B. Delayed-type hypersensitivity
C. Reaction of transplantation immunity
D. Normergic reaction
E. Granulomatosis
121. While examining the oral cavity a
stomatologist revealed inflammation of
papillae on the border of the median
and posterior third of the back of tongue.
What papillae are inflamed?
A. Papillae vallatae
B. Papillae fungiformes
C. Papillae foliatae
D. Papillae filiformes
E. Papillae conicae
122. Autopsy of a 50-year-old man
revealed the following changes: his right
lung was moderately compact in all parts,
the dissected tissue was found to be ai-
rless, fine-grained, dryish. Visceral pleura
had greyish-brown layers of fibrin. What
is the most likely diagnosis?
A. Croupous pneumonia
B. Tuberculosis
C. Bronchopneumonia
D. Interstitial pneumonia
E. Pneumofibrosis
123. In the pubertal period cells of
the male sexual glands start producing
the male sexual hormone testosterone
that is responsible for formation of the
secondary sexual characters. What cells
of the male sexual glands produce this
hormone?
A. Leidig cells
B. Sustenocytes
C. Sertoli’s cells
D. Sustentacular cells
E. Spermatozoa
124. Examination of a patient revealed
overgrowth of facial bones and soft
tissues, tongue enlargement, wide
interdental spaces in the enlarged dental
arch. What changes of the hormonal
secretion are the most likely?
A. Hypersecretion of the somatotropic
hormone
B. Hyposecretion of the somatotropic
hormone
C. Hypersecretion of insulin
D. Hyposecretion of thyroxin
E. Hyposecretion of insulin
125. Autopsy of a man, who had been
suffering from the multiple bronchiectasis
 Krok 1 Medicine 2009
for 5 years and died from chronic renal
insufficiency, revealed that kidneys were
dense and enlarged, with thickened corti-
cal layer of white colour with greasy lustre.
What renal disease might be suspected?
A. Secondary amyloidosis
B. Glomerulonephritis
C. Chronic pyelonephritis
D. Necrotic nephrosis
E. -
126. Autopsy of a 49-year-old woman
who died from chronic renal insufficiency,
revealed: kidneys were dense, reduced,
multicoloured, with haemorrhagic areas.
Microscopic examination revealed some
hematoxylin bodies in the nuclei of
the renal tubule epithelium; "wire-
loop"thickening of the glomerular capi-
llary basement membrane; here and there
in the capillaries some hyaline thrombi
and foci of fibrinoid necrosis were present.
What is the most likely diagnosis?
A. Systemic lupus erythematosus
B. Rheumatism
C. Arteriosclerotic pneumosclerosis
D. Amyloidosis
E. Atherosclerotic nephrosclerosis
127. As a result of durative antibiotic
therapy a 37-year old patient developed
intestinal dysbacteriosis. What type of
drugs should be used in order to normali-
ze intestinal microflora?
A. Eubiotics
B. Sulfanilamides
C. Bacteriophages
D. Autovaccines
E. Vitamins
128. A married couple came to the genetic
counseling. The husband suffers from the
insulin-dependant diabetes, the wife is
healthy. What is the probability that this
couple will have an insulin-dependant chi-
ld?
A. Higher than throughout the population
B. The same as throughout the population
C. Lower than throughout the population
D. 100%
E. 50%
129. An elderly female patient suffers
from the type 2 diabetes mellitus
accompanied by obesity, atherosclerosis,
coronary artery disease. Basal hyperi-
nsulinemia is also present. What
treatment would be the most appropriate?
15
A. Glibenclamid
B. Insulin
C. Retabolil
D. Lovastatin
E. Amlodipine
130. A 32-year-old patient consulted a
doctor about the absence of lactation
after parturition. Such disorder might be
explained by the deficit of the following
hormone:
A. Prolactin
B. Somatotropin
C. Vasopressin
D. Thyrocalcitonin
E. Glucagon
131. Preventive examination of a pati-
ent revealed an enlarged lymph node of
metastatic origin on the medial wall of the
left axillary crease. Specify the most likely
localization of the primary tumour:
A. Mammary gland
B. Submandibular salivary gland
C. Lung
D. Stomach
E. Thyroid gland
132. A man suffering from osteochondrosis
got acute pain in the abdominal muscles
(lateral and anterior). During objective
examination a physician diagnosticated
increased pain sensitivity of skin in the
hypogastric region. This pain might be
caused by affection of the following nerve:
A. Iliohypogastric
B. Sciatic
C. Obturator
D. Femoral
E. Genitofemoral
133. Pyeloureterography X-ray photo
showed a renal pelvis with minor calyces
only (major calyces were absent). What
form of urinary tracts of a kidney was
revealed?
A. Embryonal
B. Fetal
C. Mature
D. Ampullar
E. -
134. Autopsy of a man who died
from influenza revealed that the heart
was slightly enlarged and pastose. The
surface of the incision of myocardium
appeared to be pale, with specks. Mi-
croscopic examination revealed signs of
parenchymatous adipose and hydropic
 Krok 1 Medicine 2009
degeneration, edematic stroma with scant
lymphocytic and macrophage infiltration;
plethoric vessels; perivascular petechial
haemorrhages. What type of myocarditis
is it?
A. Serous diffuse
B. Interstitial proliferative
C. Serous focal
D. Purulent
E. Granulomatous
135. In spite of treatment with cardiotoni-
cs and thiazide diuretic a patient suffering
from chronic cardiac failure still presents
with edemata and faces a risk of ascites.
What medication should be administered
in order to increase the diuretic effect of
the above mentioned drugs?
A. Spironolactone
B. Furosemide
C. Amiloride
D. Clopamide
E. Manithol
136. Gynecological examination of the
uterine cervix in a 30-year-old woman
revealed some bright-red lustrous spots
that easily bleed when touched. Biopsy
showed that a part of the uterine cervix
was covered with cylindrical epithelium
with papillary outgrowths; in the depth of
tissue the growth of glands was present.
What pathology of the uterine cervix was
revealed?
A. Pseudoerosion
B. True erosion
C. Endocervicitis
D. Glandular hyperplasia
E. Leukoplakia
137. A stillborn child was found to have
thickened skin resembling of the tortoi-
se shell, underdeveloped auricles. Hi-
stological examination of skin revealed
hyperkeratosis, atrophy of the granular
epidermis layer; inflammatory changes
were not present. What is the most likely
diagnosis?
A. Ichthyosis
B. Leukoplakia
C. Xerodermia
D. Erythroplakia
E. Dermatomyositis
138. A patient presents with twilight visi-
on impairment. Which of the following
vitamins should be administered?
16
A. Retinol acetate
B. Cyanocobalamin
C. Pyridoxine hydrochloride
D. Ascorbic acid
E. Nicotinic acid
139. A female patient consulted a doctor
about pain and limited movements in
the knee joints. Which of the followi-
ng nonsteroid anti-inflammatory drugs
should be administered taking into consi-
deration that the patient has a history of
chronic gastroduodenitis?
A. Celecoxib
B. Diclofenac sodium
C. Promedol
D. Acetylsalicilic acid
E. Butadiounum
140. Depressions and emotional insaniti-
es result from the deficit of noradrenalin,
serotonin and other biogenic amines in
the brain. Their concentration in the
synapses can be increased by means of the
antidepressants that inhibit the following
enzyme:
A. Monoamine oxidase
B. Diamine oxidase
C. L-amino-acid oxidase
D. D-amino-acid oxidase
E. Phenylalanine-4-monooxygenase
141. A patient presents with icteriti-
ousness of skin, scleras and mucous
membranes. Blood plasma the total bili-
rubin is increased, stercobilin is increased
in feces, urobilin is increased in urine.
What type of jaundice is it?
A. Haemolytic
B. Gilbert’s disease
C. Parenchymatous
D. Obturational
E. Cholestatic
142. A pathology-histology laboratory
received a vermiform appendix up to 2,0
cm thick. Its serous membrane was pale,
thick and covered with yellowish-green fi-
lms. The wall was flaccid, of grayish-red
colour. The appendix lumen was dilated
and filled with yellowish-green substance.
Histological examination revealed that
the appendix wall was infiltrated with
neutrophils. Specify the appendix disease:
 Krok 1 Medicine 2009 17

A. Acute phlegmonous appendicitis 147. A student came to see a doctor

B. Acute gangrenous appendicitis and asked to administer him a drug for
C. Acute superficial appendicitis treatment of allergic rhinitis that occurs in
D. Acute simple appendicitis the period of linden flowering. What drug
E. Chronic appendicitis may be used?
143. While on holiday in the countryside A. Loratadine
a boy found a spider with the followi- B. Noradrenaline hydrotartrate
ng morphological peculiarities: body C. Propanolol
length of 2 cm, round black abdomen D. Ambroxol
with two rows of red dots on its dorsal E. Losartan
surface, four pairs of segmented extremi-
ties covered with tiny black hairs. Identify 148. In an embryo the process of dorsal
this arthropod: mesoderm segmentation and somite
formation is disturbed. What part of
A. Karakurt spider skin will probably have developmental
B. Scorpion abnormalities?
C. Solifugae
D. Mite A. Dermis
E. Tarantula B. Hair
C. Sebaceous glands
144. As a result of a trauma a patient has D. Epidermis
developed traumatic shock that led to the E. Perspiratory glands
following disorders: AP is 140/90 mm Hg,
Ps is 120 bpm. The patient is fussy, talkati- 149. A 9-month-old infant is fed with arti-
ve, pale. Such state relates to the following ficial formulas with unbalanced vitamin
shock phase: B6 concentration. The infant presents
with pellagral dermatitis, convulsions,
A. Erectile anaemia. Convulsion development might
B. Latent period be caused by the disturbed formation of:
C. Terminal
D. Torpid A. GABA
E. - B. Histamine
C. Serotonin
145. Examination of a patient admitted to D. DOPA
the surgical department with symptoms of E. Dopamine
acute appendicitis revealed the following
changes in the white blood cells: the total 150. During an experiment the myotatic
count of leukocytes is 16 · 109 /l. Leukocyte reflex has been studied in frogs. After
formula: basophils - 0, eosinophils - 2%, extension in a skeletal muscle its
juvenile forms - 2%, stabnuclear - 8%, reflectory contraction was absent. The
segmentonuclear - 59%, lymphocytes reason for it might be a dysfunction of
- 25%, monocytes- 4%. The described the following receptors:
changes can be classified as:
A. Muscle spindles
A. Neutrophilia with regenerative left shift B. Nociceptors
B. Neutrophilia with right shift C. Articular
C. Neutrophilia with degenerative left shift D. Golgi tendon organs
D. Neutrophilic leukemoid reaction E. Tactile
E. Neutrophilia with hyperregenerative
left shift 151. During an experiment vagus
branches that innervate heart are being
146. After a trauma a patient lost ability stimulated. This has stopped conduction
of elbow extension. This might have been of excitement from the atria to the ventri-
caused by dysfunction of the following cles. The reason for it are electrophysical
main muscle: changes in the following structures:
A. m. triceps brachii A. Atrioventricular node
B. m. subscapularis B. His’ bundle
C. m. teres major C. Sinoatrial node
D. m. infraspinatus D. Ventricles
E. m. levator scapulae E. Atria
 Krok 1 Medicine 2009
152. A man has worked in an Afri-
can country for 3 years. A month after
his return to Ukraine he consulted
an ophthalmologist and complained
about eye ache, eyelid edema, lacrimati-
on and temporary visual impairment.
Underneath the eye conjunctiva the
doctor revealed helminths 30-50 mm long
with elongated filiform body. What di-
agnosis might be suspected?
A. Filariasis
B. Diphyllobothriasis
C. Ascaridiasis
D. Enterobiasis
E. Trichocephaliasis
153. After a disease a 16-year-old boy
is presenting with decreased function of
protein synthesis in the liver as a result of
vitamin K deficiency. This may cause di-
sorder of:
A. Blood coagulation
B. Erythrocyte sedimentation rate
C. Anticoagulant production
D. Erythropoietin production
E. Osmotic blood pressure
154. In response to a change in body posi-
tion from horizontal to vertical blood
circulation system develops reflectory
pressor reaction. Which of the following
is its compulsory component?
A. Systemic constriction of the venous
vessels
B. Systemic dilatation of the arterial resi-
stive vessels
C. Decrease in the circulating blood
volume
D. Increase in the heart rate
E. Weakening of the pumbing ability of
heart
155. Life cycle of a cell includes a
process of DNA autoreduplication. As
a result of this process monochromatid
chromosomes become bichromatid. This
phenomenon is observed within the
following period of the cell cycle:
A. S
B. G0
C. G1
D. G2
E. M
156. As a result of a road accident a driver
has gotten a trauma. Now he is in shock
condition and presents with a decrease in
daily diuresis down to 300 ml. What is the
main pathogenetic factor of such alterati-
18
on in the diuresis?
A. Arterial pressure drop
B. Oncotic blood pressure drop
C. Increase in vascular permeability
D. Decrease in number of the functioning
glomerules
E. Secondary hyperaldosteronism
157. Examination of a patient revealed
autoimmune haemolytic anaemia
(cytotoxic type). What substances act as
antigens in the II-type allergic reactions?
A. Modified receptors of cell membranes
B. Antibiotics
C. Hormones
D. Serum proteins
E. Inflammation modulators
158. A patient suffers from the
haemorrhagic syndrome that shows itself
in frequent nasal bleedings, posttraumatic
and spontaneous intracutaneous and
intra-articular haemorrhages. After a
laboratory study a patient was diagnosed
with the type B haemophilia. This disease
is provoked by the deficit of the following
factor of blood coagulation:
A. IX
B. VIII
C. XI
D. V
E. VII
159. After a craniocerebral trauma a pati-
ent lost the ability to execute learned
purposeful movements (apraxia). The
injury is most likely localized in the
following region of the cerebral cortex:
A. Gyrus supramarginalis
B. Gyrus angularis
C. Gyrus paracentralis
D. Gyrus lingualis
E. Gyrus parahippocampalis
160. A 58-year-old patient suffers from
the cerebral atherosclerosis. Examinati-
on revealed hyperlipoidemia. What class
of lipoproteins will most probably show
increase in concentration in this patient’s
blood serum?
A. Low-density lipoproteins
B. High-density lipoproteins
C. Fatty acid complexes with albumins
D. Chylomicrons
E. Cholesterol
161. A patient consulted a physician about
muscle rigidity, constrained movements,
 Krok 1 Medicine 2009
permanent arm tremor. The patient was
diagnosed with Parkinson’s disease. What
preparation should be administered?
A. Levodopa
B. Phenytoin
C. Phenobarbital
D. Diazepam
E. Ethosuximide
162. A patient with coronary artery di-
sease was admitted to the cardiological
department. For stenocardia prevention
a drug from the group of β-adrenoceptor
blockers was administered. What drug is
it?
A. Metoprolol
B. Atropine sulfate
C. Morphine hydrochloride
D. Oxytocin
E. Furosemide
163. A 28-year-old female patient
consulted a gynecologist about sterility.
Examination revealed underdeveloped
ovaries and uterus, irregular menstrual
cycle. Analysis of the sex chromatin
revealed 2 Barr’s bodies in most somatic
cells. What chromosome disease is most
likely?
A. Triple X syndrome
B. Edwards’ syndrome
C. Patau’s syndrome
D. Klinefelter’s syndrome
E. Turner’s syndrome
164. A patient with drug intoxication
presented with the dryness of oral mucous
membrane and mydriatic pupils. Such
action of this drug is associated with the
following effect:
A. Muscarinic cholinoreceptor block
B. Muscarinic cholinoreceptor stumulation
C. Nicotinic cholinoreceptor stumulation
D. Adrenoreceptor stimulation
E. Adrenoreceptor block
165. A newborn develops dyspepsia
after the milk feeding. When the mi-
lk is substituted by the glucose solution
the dyspepsia symptoms disappear. The
newborn has the subnormal activity of the
following enzyme:
A. Lactase
B. Invertase
C. Maltase
D. Amylase
E. Isomaltase
19
166. A man presents with increased heart
rate, mydriatic pupils, dry mouth. This
condition results from the activation of
the following system of function regulati-
on:
A. Sympathetic
B. Parasympathetic
C. Metasympathetic
D. Vago-insular
E. Hypothalamo-pituitary-adrenal
167. A patient with a limb fracture must
be administered a depolarizing drug from
the myorelaxant group for the purpose of
a short-time surgery. What drug is it?
A. Dithylinum
B. Tubocurarine chloride
C. Cytitonum
D. Atropine sulfate
E. Pentaminum
168. A patient suffering from chronic
bronchitis takes a synthetic mucolytic
drug that facilitates the sputum thinning.
What drug is it?
A. Acetylcysteine
B. Diazepam
C. Heparin
D. Furosemide
E. Enalapril
169. A patient with massive burns
developed acute renal insufficiency
characterized by a significant and
rapid deceleration of glomerular fi-
ltration. What is the mechanism of its
development?
A. Reduction of renal blood flow
B. Damage of glomerular filter
C. Reduction of functioning nephron
number
D. Rise of pressure of tubular fluid
E. Renal artery embolism
170. A patient with severe course of respi-
ratory viral infection presented with clini-
cal signs of progressing heart failure that
led to his death in the 2nd week of disease.
Autopsy revealed that the heart caviti-
es were significantly dilated, the heart
was flabby. Histological examination of
the myocardium revealed microvascular
plethora and diffuse stroma infiltration
with lymphocytes and histiocytes. What
is the most likely diagnosis?
 Krok 1 Medicine 2009
A. Myocarditis
B. Stenocardia
C. Acute coronary insufficiency
D. Myocardial infarction
E. Cardiomyopathy
171. During the regular sanitary-
epidemiological inspection of a pharmacy,
the bacteriological analysis of air was
performed. The air was found to have
bacilli, yeast fungi, hemolytic streptococci,
micrococci. Which of the detected mi-
croorganisms indicate the direct epidemic
danger?
A. Haemolytic streptococci
B. Micrococci
C. Bacilli
D. Yeast fungi
E. -
172. A man with an injury in the nuchal
region (regio nuchae) was admitted to the
resuscitation department. What muscle
occupies this region?
A. m. trapezius
B. m. sternocleidomastoideus
C. m. latissimus dorsi
D. m. rhomboideus minor
E. m. scalenus anterior
173. A section of the left lung was found
to have an area of dense red tissue. The
area was cone-shaped, stood out distinctly
from the healthy tissue, with its base di-
rected to the pleura. The dissected tissue
was granular, dark-red. What is the most
likely diagnosis?
A. Haemorrhagic infarction
B. Lung abscess
C. Lung gangrene
D. Primary tuberculous affection
E. Croupous pneumonia
174. An animal has an increased tonus
of extensor muscles. This the result
of intensified information transmissi-
on to the motoneurons of the spinal
cord through the following descending
pathways:
A. Vestibulospinal
B. Medial corticospinal
C. Reticulospinal
D. Rubrospinal
E. Lateral corticospinal
175. Following exposure to radiation a
lot of mutant cells appeared in a pati-
ent. Some time later most of them were
detected and destroyed by the following
20
cells of the immune system:
A. T -lymphocytes-killers
B. Plasmoblasts
C. T -lymphocytes-supressors
D. B-lymphocyte
E. Stem cells
176. A 65-year-old man has purulent
abscess on his neck. Analyses revealed
a culture of gram-positive cocci with
plasmocoagulase activity. This culture
relates most likely to:
A. Staphylococcus aureus
B. Streptococcus pyogenes
C. Staphylococcus epidermidis
D. Staphylococcus saprophyticus
E. -
177. In clinical practice tuberculosis is
treated with izoniazid preparation - that
is an antivitamin able to penetrate into
the tuberculosis bacillus. Tuberculostatic
effect is induced by the interference wi-
th replication processes and oxidation-
reduction reactions due to the buildup of
pseudo-coenzyme:
A. NAD
B. FAD
C. FMN
D. TDP
E. CoQ
178. A newborn child was found to have
reduced intensity of sucking, frequent
vomiting, hypotonia. Urine and blood
exhibit increased concentration of citrulli-
ne. What metabolic process is disturbed?
A. Ornithinic cycle
B. Tricarboxylic acid cycle
C. Glycolysis
D. Glyconeogenesis
E. Cori cycle
179. Vagus nerves of an experimental ani-
mal have been cut on the both sides. What
respiratory changes will result from this?
A. Respiration will become deep and
infrequent
B. Respiration will become shallow and
frequent
C. Respiration will become deep and
frequent
D. Respiration will become shallow and
infrequent
E. There will be no respiratory changes
180. Before tooth extraction a patient
was advised to take a certain drug for
 Krok 1 Medicine 2009 21

haemorrhage prevention. What drug was A. Medial brachial cutaneous nerve

advised? B. Medial antebrachial cutaneous nerve
C. Radial nerve
A. Vicasolum D. Ulnar nerve
B. Heparin E. Axillary nerve
C. Asparcam
D. Magnesium sulfate 186. Examination of a young woman
E. Dimedrol revealed a tumour up to 3 cm in di-
ameter in form of a knot localized
181. A patient who has been taking a drug along the acoustic nerve. The tumour is
for a long time cannot abruptly stop its homogenous, soft and elastic, of pink-
use, because this may lead to psychic and and-white colour. Microscopically the
somatic dysfunctions. Name the syndrome tumour contains clusters of cells with oval
of different disorders caused by a drug wi- nuclei. Fibrous cell clusters form regular
thdrawal: structures made up by parallel rows of
regularly oriented cells arranged in form
A. Abstinence of a palisade. Zones between the rows
B. Sensibilization of cells are acellular and homogenous
C. Idiosyncrasy (Verocai bodies). What tumour is it?
D. Tachyphylaxis
E. Cumulation A. Neurinoma
B. Malignant neurinoma
182. A 45-year-old patient suffers from C. Ganglioneuroma
neurosis characterized by irritability, D. Neuroblastoma
sleeplessness, motiveless anxiety. What E. Ganglioneuroblastoma
drug would eliminate all the symptoms?
187. A patient with myocardial infarcti-
A. Diazepam on was admitted to the cardiological
B. Valerian extract department. For pain relief it was deci-
C. Pyracetam ded to potentiate fentanyl action wi-
D. Caffeine sodium benzoate th a neuroleptic. Which of the followi-
E. Levodopa ng neuroleptics is the most suitable for
183. After taking poor-quality food a pati- neuroleptanalgesia?
ent developed repeated episodes of di- A. Droperidol
arrhea. On the next day he presented with B. Aminazine
decreased arterial pressure, tachycardia, C. Triftazine
extrasystole. Blood pH is 7,18. These D. Haloperidol
abnormalities were caused by the E. Sulpiride
development of:
188. Treatment course of bacterial
A. Nongaseous acidosis pneumonia included benzylpenicillin
B. Gaseous acidosis sodium salt. What is the mechanism of
C. Nongaseous alkalosis its antimicrobial action?
D. Gaseous alkalosis
E. Metabolic alkalosis A. Inhibition of cell wall synthesis of the
microorganism
184. Which muscle contraction will be B. Inhibition of the intracellular protein
observed in the upper extremity during synthesis
holding (not moving) a load in a certain C. Inhibition of the cholinesterase activity
position? D. Inhibition of the SH enzyme groups of
the microorganisms
A. Isometric E. Antagonism with the paraaminobenzoic
B. Isotonic acid
C. Auxotonic
D. Concentric 189. A 49-year-old driver complains about
E. Excentric unbearable constricting pain behind the
breastbone irradiating to the neck. The
185. A patient has lost skin sensitivity in pain arose 2 hours ago. Objectively: the
the region of the medial surface of his patient’s condition is grave, he is pale,
shoulder. This is the result of dysfuncti- heart tones are decreased. Laboratory
on of the following nerve: studies revealed high activity of creatine
kinase and LDH1 . What disease are these
 Krok 1 Medicine 2009 22

symptoms typical for? A. B, α (III) Rh−

B. A, β (II) Rh−
A. Acute myocardial infarction C. 0, α, β, (I) Rh+
B. Acute pancreatitis D. AB (IV ), Rh+
C. Stenocardia
D. Cholelithiasis E. AB (IV ), Rh−
E. Diabetes mellitus 194. Pharmacological effects of anti-
190. A 60-year-old patient presents wi- depressants are based upon blocking
th weakened peristaltic activity of the (inhibiting) the enzyme that acts as a
bowels. Which of the following foodstuffs catalyst for the breakdown of biogenic
would stimulate peristalsis most of all? amines noradrenalin and serotonin in the
mitochondria of cephalic neurons. What
A. Brown bread enzyme takes part in this process?
B. White bread
C. Meat A. Monoamine oxidase
D. Lard B. Transaminase
E. Tea C. Decarboxylase
D. Peptidase
191. After inoculation of the material E. Lyase
obtained from the pharynx of an angina
patient onto the blood-tellurite agar, grey 195. An oncological patient was admini-
colonies could be observed. They were stered methotrexate. With the lapse of
4-5 mm in diameter, radially striated (in time the target cells of the tumour lost
sensitivity to this preparation. We can
form of rosettes). Microscopical exami- observe changes in the gene expression
nation revealed gram-positive bacilli wi- of the following enzyme:
th clavate swollen ends arranged in form
of wide-spread fingers. Identify these mi- A. Dihydrofolate reductase
croorganisms: B. Thiminase
C. Desaminase
A. Diphtheria corynebacteria D. Folate oxidase
B. Clostridium botulinum E. Folate decarboxylase
C. Diphtheroids
D. Streptococci 196. A patient with a hypertensive cri-
E. Streptobacilli sis was admitted to the cardiological
department. He was given an intravenous
192. A microspecimen of the submandi- injection of an antihypertensive drug -
bular salivary gland shows some basket- alkali-earth metal salt. What drug was
shaped cells concentrated around the injected?
acines and excretory ducts. These cells
surround bases of the serous cells and A. Magnesium sulfate
are called myoepitheliocytes. These cells B. Potassium chloride
relate to the following tissue: C. Sodium hydrocarbonate
D. Calcium lactate
A. Muscular tissue E. Benzohexonium
B. Epithelial tissue
C. Neural tissue 197. An injured person was delivered to
D. Special connective tissue the hospital with a penetrating wound in
E. Loose fibrous connective tissue the left lateral region of abdomen. What
part of the large intestine is most likely
193. It was established that agglutinati- damaged?
on of the recipient’s blood erythrocytes
had been caused by the standard sera A. Colon descendens
from the I and II groups. Serum from B. Colon ascendens
the III group as well as anti-Rh serum C. Colon transverses
hadn‘t provoke any agglutination. Which D. Caecum
blood group and rhesus is allowed to be E. Rectum
transfused this recipient?
198. After a road accident a driver was
delivered to the hospital with an injury of
the medial epicondyle of humerus. What
nerve might be damaged in this case?
 Krok 1 Medicine 2009 23

A. n. ulnaris 200. Examination of the anterior abdomi-

B. n. radialis nal wall of a pregnant woman revealed
C. n. axillaris a tumour-like formation that arose on
D. n. muscolocutaneus the spot of a tumour that was removed
E. n. medianus two years ago. The neoplasm was well-
defined, dense, 2х1 cm large. Histological
199. A man with a stab wound in the regi- examination revealed that the tumour was
on of the quadrilateral foramen consulted composed of differentiated connective ti-
a doctor about it. Examination revealed ssue with prevailing collagen fibres. What
that the injured couldn’t abduct his arm tumour might be suspected?
from the body. What nerve is most likely
damaged? A. Desmoid
B. Lipoma
A. n. axillaris C. Fibrosarcoma
B. n. medianus D. Hibernoma
C. n. radialis E. Leiomyoma
D. n. ulnaris
E. n. subclavius
 Krok 1 Medicine 2010 1

1. An unconscious patient was deli- A. Tryptophan

vered to the admission ward. Objecti- B. Alanine
vely: the patient’s skin is cold, pupils are C. Histidine
myotic, he has laboured Cheyne-Stokes D. Methionine
respiration, arterial pressure is low, uri- E. Tyrosine
nary bladder is full. What substance has
caused intoxication? 6. Blood of a 12 year old boy presents low
concentration of uric acid and accumulati-
A. Narcotic analgetics on of xanthine and hypoxanthine. This
B. Tranquilizers child has genetic defect of the following
C. Non-narcotic analgetics enzyme:
D. Muscarinic receptor blockers
E. - A. Xanthine oxidase
B. Arginase
2. Characteristic sign of glycogenosis C. Urease
is muscle pain during physical work. D. Ornithine carbamoyltransferase
Blood examination reveals usually E. Glycerylkinase
hypoglycemia. This pathology is caused
by congenital deficiency of the following 7. A patient who suffers from insomnia
enzyme: caused by emotional disorder was prescri-
bed a hypnotic drug with tranquillizing
A. Glycogen phosphorylase effect. What hypnotic was prescribed?
B. Glucose 6-phosphate dehydrogenase
C. Alpha amylase A. Nitrazepam
D. Gamma amylase B. Phenobarbital
E. Lysosomal glycosidase C. Chloral hydrate
D. Sodium ethaminal
3. A woman works as railway traffic E. Bromisoval
controller. She suffers from seasonal
vasomotor rhinitis and gets treatment in 8. A patient is ill with diabetes melli-
the outpatient setting. She was prescribed tus accompanied by hyperglycemia on
an antihistamine that has no effect upon an empty stomach (7,2 millimole/l). The
central nervous system. What drug is it? hyperglycemia rate can be retrospecti-
vely estimated (over the last 4-8 weeks
A. Loratadine before the examination) on the ground
B. Dimedrol of the rate of the following blood plasma
C. Promethazine protein:
D. Suprastin
E. Tavegil A. Glycated hemoglobin
B. Albumin
4. During an operation a patient got C. Fibrinogen
injection of muscle relaxant dithylinum. D. C-reactive protein
Relaxation of skeletal muscles and inhibi- E. Ceruloplasmin
tion of respiration lasted two hours. This
condition was caused by absence of the 9. In course of laparotomy a surgeon
following enzyme in blood serum: revealed gangrenous lesion of descendi-
ng colon. It was caused by thrombosis of
A. Butyrylcholin esterase the following artery:
B. Catalase
C. Acetylcholinesterase A. Sinister colic
D. Glucose 6-phosphatase B. Median colic
E. Glutathione peroxidase C. Dexter colic
D. Ileocolic
5. Examination of a patient suffering from E. Superior mesenteric artery
cancer of urinary bladder revealed high
rate of serotonin and hydroxyanthranilic 10. A 60 year old patient has impai-
acid. It is caused by excess of the followi- red perception of high-frequency sounds.
ng amino acid in the organism: These changes were caused by damage of
the following auditory analyzer structures:
 Krok 1 Medicine 2010
A. Main cochlea membrane near the oval
window
B. Main cochlea membrane near the
helicotrema
C. Eustachian tube
D. Middle ear muscles
E. Tympanic membrane
11. A patient has low rate of magnesium
ions that are necessary for affixion of ri-
bosomes to the endoplasmic reticulum.
It is known that it causes disturbance
of protein biosynthesis. At what stage is
protein biosynthesis impaired?
A. Translation
B. Transcription
C. Replication
D. Amino acid activation
E. Termination
12. A healthy man is in a region with hi-
gh risk of catching malaria. What drug
should be administered for individual
chemoprophylaxis of malaria?
A. Chingamin
B. Sulfalen
C. Tetracycline
D. Metronidazole
E. Biseptol
13. A full-term newborn child has yellowi-
sh skin and mucous membranes. This mi-
ght be probably caused by temporary defi-
ciency of the following enzyme:
A. UDPglucoronyltransferase
B. Uridine transferase
C. Heme synthetase
D. Heme oxygenase
E. Biliverdin reductase
14. A patient ill with neurodermatitis has
been taking prednisolone for a long time.
Examination revealed high rate of sugar
in his blood. This complication is caused
by the drug influence upon the following
link of carbohydrate metabolism:
A. Gluconeogenesis activation
B. Glycogenogenesis activation
C. Intensification of glucose absorption in
the bowels
D. Inhibition of glycogen synthesis
E. Activation of insulin decomposition
15. Labelled amino acids alanine and
tryptophane were injected to a mouse
in order to study localization of protein
synthesis in its cells. The labelled ami-
no acids will be accumulated near the
following organellas:
2
A. Ribosomes
B. Smooth endoplasmic reticulum
C. Cell centre
D. Lysosomes
E. Golgi apparatus
16. Students who are taking examinations
often have dry mouth. The mechanism
that causes this state is the realization of
the following reflexes:
A. Conditioned sympathetic
B. Unconditioned parasympathetic
C. Conditioned parasympathetic
D. Unconditioned sympathetic
E. Unconditioned peripheral
17. Inflammation of the tympanic cavity
(purulent otitis media) was complicated
by inflammation of mammillary process
sockets. What wall of tympanic cavity
did the pus penetrate into the sockets
through?
A. Posterior
B. Anterior
C. Medial
D. Lateral
E. Superior
18. Examination of a patient revealed
typical presentations of collagenosis. This
pathology is characterized by increase of
the following urine index:
A. Hydroxyproline
B. Arginine
C. Glucose
D. Mineral salts
E. Ammonium salts
19. Untrained people often have muscle
pain after sprints as a result of lactate
accumulation. This might be caused by
intensification of the following biochemi-
cal process:
A. Glycolysis
B. Gluconeogenesis
C. Pentose phosphate pathway
D. Lipogenesis
E. Glycogenesis
20. Examination of a patient sufferi-
ng from frequent haemorrhages in the
inner organs and mucous membranes
revealed proline and lysine being included
in collagen fibers. Impairment of their
hydroxylation is caused by lack of the
following vitamin:
 Krok 1 Medicine 2010 3

A. C resulted in remission but the patient got

B. E exacerbation of chronic tonsillitis. This
C. K complication is induced by the following
D. A effect of glucocorticosteroids:
E. D
A. Immunosuppressive
21. During an experiment a skeletal B. Anti-inflammatory
muscle is stimulated by a series of electric C. Anti-shock
impulses. What type of muscle contracti- D. Antiallergenic
on will be observed provided that each E. Antitoxic
subsequent impulse comes in the peri-
od of shortening of the previous single 26. A 62 year woman complai-
muscle contraction? ns of frequent pain attacks in the
area of her chest and backbone, rib
A. Holotetanus fractures. Her doctor suspected myeloma
B. Partial tetanus (plasmocytoma). What of the following
C. Asynchronous tetanus laboratory characteristics will be of the
D. A series of single contractures greatest diagnostic importance?
E. Muscle contracture
A. Paraproteinemia
22. A 48 year old patient complai- B. Hyperalbuminemia
ned about intense pain, slight swelli- C. Proteinuria
ng and reddening of skin over the joi- D. Hypoglobulinemia
nts, temperature rise up to 38o C. Blood E. Hypoproteinemia
analysis revealed high concentration of
urates. This condition might be caused by 27. A newborn child has convulsions that
disturbed metabolism of: have been observed after prescription of
vitamin B6 . This most probable cause of
A. Purines this effect is that vitamin B6 is a componet
B. Collagen of the following enzyme:
C. Cholesterol
D. Pyrimidines A. Glutamate decarboxylase
E. Carbohydrates B. Pyruvate dehydrostase
C. Netoglubarate dehydromine
23. An experimantal animal that was kept D. Aminolevulinate synthase
on protein-free diet developed fatty li- E. Glycogen phosphorylase
ver infiltration, in particular as a result
of deficiency of methylating agents. This 28. A patient who has been abusing
is caused by disturbed generation of the tobacco smoking for a long time has got
following metabolite: cough accompanied by excretion of vi-
scous mucus; weakness after minor physi-
A. Choline cal stress, pale skin. The patient has also
B. DOPA lost 12,0 kg of body weight. Endoscopic
C. Cholesterol examination of biosy material his illness
D. Acetoacetate was diagnosed as squamous cell carci-
E. Linoleic acid noma. Name a pathological process that
preceded formation of the tumour:
24. A 46 year old woman suffering from
chololithiasis developed jaundice. Her A. Metaplasia
urine became dark-yellow and feces B. Hypoplasia
became colourless. Blood serum will have C. Hyperplasia
the highest concentration of the following D. Necrosis
substance: E. Sclerosis
A. Conjugated bilirubin 29. Bacterioscopic examination of a smear
B. Unconjugated bilirubin from the pharynx of a diphtheria suspect
C. Biliverdin revealed bacilli with volutine granules.
D. Mesobilirubin What etiotropic drug should be chosen
E. Urobilinogen in this case?
25. A patient suffering from infecti-
ous mononucleosis has been taking
glucocorticosteroids for two weeks. This
 Krok 1 Medicine 2010 4

A. Antidiphtheritic antitoxic serum A. Obturation of biliary tracts

B. Bacteriophage B. Inflammation of mucous membrane of
C. Diphtheritic anatoxin small intestine
D. Eubiotic C. Lack of pancreatic lipase
E. Interferon D. Lack of pancreatic phospholipase
E. Unbalanced diet
30. A patient caught a cold after whi-
ch there appeared facial expression di- 35. Examination of a patient with pustular
sorder. He cannot close his eyes, raise his skin lesions allowed to isolate a causati-
eyebrows, bare his teeth. What nerve is ve agent that forms in the blood agar
damaged? roundish yellow middle-sized colonies
surrounded by haemolysis zone. Smears
A. Facial from the colonies contain irregular-
B. Vagus shaped clusters of gram-positive cocci.
C. Trigeminus The culture is oxidase- and catalase-
D. Glossopharyngeal positive, ferments mannitol and synthesi-
E. Infraorbital zes plasmocoagulase. What causative
agent was isolated?
31. A patient underwent an operation
on account of gall bladder excision that A. Staphylococcus aureus
resulted in obstruction of Ca absorption B. Streptococcus agalactiae
through the bowels wall. What vitamin C. Streptococcus pyogenes
wil stimulate this process? D. Staphylococcus epidermidis
E. Staphylococcus saprophyticus
A. D3
B. P P 36. A patient complained about being
C. C unable to adduct and abduct fingers in
D. B12 the metacarpophalangeal articulations
E. K towards and away from the 3rd finger.
Which muscles’ function is impaired?
32. A 70 year old female patient was di-
agnosed with fracture of left femoral neck A. Interosseous muscles
accompanied by disruption of ligament of B. Lumbrical muscles
head of femur. The branch of the followi- C. Breviflexors of fingers
ng artery is damaged: D. Long flexors of fingers
E. Extensors
A. Obturator
B. Femoral 37. A 44 year old woman complains of
C. External iliac general weakness, heart pain, significant
D. Inferior gluteal increase of body weight. Objectively:
E. Internal pudendal moon face, hirsutism, AP is 165/100 mm
Hg, height - 164 cm, weight - 103 kg; the
33. ECG of a patient shows prolongation fat is mostly accumulated on her neck,
of T-wave. This is caused by deceleration thoracic girdle, belly. What is the main
in ventricles of: pathogenetic mechanism of obesity?
A. Repolarization A. Increased production of glucocorticoids
B. Depolarization and repolarization B. Reduced production of thyroid
C. Depolarization hormones
D. Contraction C. Increased insulin production
E. Relaxation D. Reduced glucagon production
34. A patient complains of frequent di- E. Increased mineralocorticoid production
arrheas, especially after consumption of 38. A 34 year old woman was di-
rich food, weight loss. Laboratory exami- agnosed with hereditary microspherocytic
nation revealed steatorrhea; his feces
hemolytic anemia (Minkowsky-Shauffard
were hypocholic. What might have caused
such condition? disease). What mechanism caused
haemolysis of erythrocytes?
 Krok 1 Medicine 2010
A. Membranopathy
B. Enzymopathy
C. Hemoglobinopathy
D. Autoimmune disorder
E. Bone marrow hypoploasia
39. According to the model of double
DNA helix that was suggested by Watson
and Creek, it was established that one of
chains would not be lost during replication
and the second chain would be synthesi-
zed complementary to the first one. What
way of replication is it?
A. Semiconservative
B. Analogous
C. Identical
D. Dispersed
E. Conservative
40. A 4 year old child was admitted to
the orthopaedic department with shin
fracture together with displacement. Bone
fragments reposition requires preliminary
analgesia. What preparation should be
chosen?
A. Promedol
B. Analgin
C. Morphine hydrochloride
D. Panadol
E. -
41. A patient suffers from hepatoci-
rrhosis. State of antitoxic liver function
can be characterized by examination of
the following substance exreted by urine:
A. Hippuric acid
B. Ammonium salts
C. Creatinine
D. Uric acid
E. Amino acids
42. A 22 year old patient from the
West Ukraine complains of laboured
nasal breathing. Morphological exami-
nation of biopsy material of nasal mucous
membrane revealed lymphoid, epitheli-
oid, plasma cells as well as Mikulicz’s cells.
What is the most probable diagnosis?
A. Rhinoscleroma
B. Glanders
C. Tuberculosis
D. Leprosy
E. Syphilis
43. Vitamin A together with specific
cytoreceptors penetrates through the
nuclear membranes, induces transcripti-
on processes that stimulate growth and
differentiation of cells. This biological
5
function is realized by the following form
of vitamin A:
A. Trans-retinoic acid
B. Trans-retinal
C. Cis-retinal
D. Retinol
E. Carotin
44. During preparation of a patient to a
heart surgery it was necessary to measure
pressure in heart chambers. In one of
them pressure varied from 0 mm Hg up
to 120 mm Hg within one cardiac cycle.
What heart chamber is it?
A. Left ventricle
B. Right ventricle
C. Right atrium
D. Left atrium
E. -
45. Examination of coronary arteries
revealed atherosclerotic calcified plaques
closing vessel lumen by 1/3. The muscle
has multiple whitish layers of connective
tissue. What process was revealed in the
myocardium?
A. Diffusive cardiosclerosis
B. Tiger heart
C. Postinfarction cardiosclerosis
D. Myocarditis
E. Myocardium infarction
46. In order to determine toxigenicity of
diphtheria bacilli a strip of filter paper
impregnated with antitoxic diphtherial
serum was put on the dense nutrient medi-
um. There were also inoculated a mi-
crobal culture under examination and a
strain that is known to be toxigenic. If
the microbal culture under examinati-
on produces exotoxin, this wil result in
formation of:
A. Precipitin lines
B. Haemolysis zones
C. Zones of diffuse opacification
D. Zones of lecithovitellinous activity
E. Precipitin ring
47. A 63 year old male patient who
had been suffering from chronic di-
ffuse obstructive disease, pulmonary
emphysema, for 15 years died from cardi-
ac insufficiency. Autopsy revealed nutmeg
liver cirrhosis, cyanotic induration of ki-
dneys and spleen, ascites, edemata of
lower limbs. These changes of internal
organs are typical for the following di-
sease:
 Krok 1 Medicine 2010
A. Chronic right-ventricular insufficiency
B. Acute right-ventricular insufficiency
C. Chronic left-ventricular insufficiency
D. Acute left-ventricular insufficiency
E. General cardiac insufficiency
48. Examination of an ovary specimen
stained by hematoxylin-eosine revealed
a follicle in which follicular epithelium
consisted of 1-2 layers of cubic cells. There
was also a bright red membrane around
the ovocyte. What follicle is it?
A. Primary
B. Primordial
C. Secondary
D. Mature
E. Atretic
49. A newborn child suffers from mi-
lk curdling in stomach, this means that
soluble milk proteins (caseins) transform
to insoluble proteins (paracaseins) by
means of calcium ions and a certain
enzyme. What enzyme takes part in this
process?
A. Renin
B. Pepsin
C. Gastrin
D. Secretin
E. Lipase
50. A patient suffers from diabetes meli-
tus. After the regular insulin injecti-
on his condition grew worse: there
appeared anxiety, cold sweat, tremor
of limbs, general weakness, dizziness.
What preparation can eliminate these
symptoms?
A. Adrenaline hydrochloride
B. Butamide
C. Caffeine
D. Noradrenaline
E. Glibutide
51. A patient has difficulties with
hand movement. Examination revealed
inflammation of common synovial sheath
of flexor muscles. It is known from the
patient’s anamnesis that he got a stab
wound of finger a week ago. Which finger
was most probably damaged?
A. Digitus minimus
B. Pollex
C. Digitus medius
D. Index
E. Digitus anularis
52. Clinical diagnosis of a female pati-
ent was gonorrhoea. What examination
6
method can be applied for confirmation
of this diagnosis?
A. Microscopy of pathological material
B. Infection of laboratory animals
C. Test with bacteriophage
D. Hemagglutination reaction
E. Immobilization reaction
53. Autopsy of a man who died from
burn disease revealed brain edema, li-
ver enlargement as well as enlargement
of kidneys with wide light-grey cortical
layer and plethoric medullary area. Mi-
croscopic examination revealed necrosis
of tubules of main segments along with
destruction of basal membranes, intersti-
cium edema with leukocytic infiltrati-
on and haemorrhages. What is the most
probable postmortem diagnosis?
A. Necrotic nephrosis
B. Tubulointerstitial nephritis
C. Pyelonephritis
D. Gouty kidney
E. Myeloma kidney
54. A 30 year old man had been suffering
from acute respiratory disease and died
from cardiopulmonary decompensation.
Autopsy revealed fibrinous-haemorrhagic
inflammation in the mucous membrane
of larynx and trachea, destructive
panbronchitis, enlarged lungs that look
black due to the multiple abcesses,
haemorrhages, necrosis. What is the most
probable postmortem diagnosis?
A. Influenza
B. Parainfluenza
C. Respiratory syncytial infection
D. Measles
E. Adenoviral infection
55. A 19 year old woman suffers from
primary syphilis. Doctor administered
her complex therapy that includes
benzylpenicillin sodium salt. What is the
mechanism of action of this drug?
A. It blocks synthesis of peptidoglycan of
microbal membrane
B. It blocks synthesis of cytoplasm proteins
C. It blocks thiol enzymes
D. It blocks RNA synthesis
E. It blocks DNA synthesis
56. A 65 year old female patient
suffers from chronic renal insufficiency
accompanied by evident edemata caused
by chronic glomerulonephritis. What di-
uretic should be administered for forced
diuresis?
 Krok 1 Medicine 2010
A. Furosemide
B. Hydrochlorothiazide
C. Chlorthalidone
D. Cyclometazide
E. Acetazolamide
57. 6 months after labour a woman
had uterine hemorrhage. Gynaecologi-
cal examination of uterine cavity revealed
a dark-red tissue with multiple cavities
resembling of a "sponge". Microscopic
examination of a tumour revealed in
blood lacunas atypic light epithelial
Langhans cells and giant cells of syncyti-
otrophoblast. What tumour is it?
A. Chorioepithelioma
B. Squamous cell nonkeratinous carci-
noma
C. Adenocarcinoma
D. Fibromyoma
E. Cystic mole
58. 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:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
59. A patient suffering from periodical
attacks caused by inhalation of different
flavoring substances was diagnosed with
atopic bronchial asthma. IgE level was
increased. This is typical for the followi-
ng type of reactions:
A. Anaphylactic reactions
B. Cytotoxic reactions
C. Immunocomplex reactions
D. delayed-type hypersensitivity
E. Autoimmune reactions
60. During regular examination of
schoolchildren it was revealed that a 10
year old girl had asymmetric oval eggs wi-
th a larva in the scrape from her perianal
folds. What diagnosis should be made?
A. Enterobiasis
B. Ascariasis
C. Amebiasis
D. Trichocephalosis
E. Ankylostomiasis
61. Histological examination of a 40 year
7
old man’s thymus revealed reduced share
of parenchymatous elements, increased
share of adipose and loose connective ti-
ssue, its enrichment with thymus bodies.
The organ’s mass was unchanged. What is
this phenomenon called?
A. Age involution
B. Accidental involution
C. Hypotrophy
D. Dystrophy
E. Atrophy
62. A 56 year old patient suffering from
cardiac insufficiency has edema of feet
and shins, edematous skin is pale and cold.
What is the leding mechanism of edema
pathogenesis?
A. Rise of hydrostatic pressure in venules
B. Drop of oncotic pessure in capillaries
C. Increase of capillary permeability
D. Disorder of lymph outflow
E. Positive water balance
63. Researchers of a bacteriological
laboratory examine tinned meat for
botulinic toxin. For this purpose a group
of mice was injected with an extract of the
material under examination and antitoxic
antibotulinic serum of A, B, E types. A
control group of mice was injected with
the same extract but without antibotuli-
nic serum. What serological reaction was
applied?
A. Neutralization
B. Precipitation
C. Complement binding
D. Opsonocytophagic
E. Double immune diffusion
64. A clinic observes a 49 year old
patient with significant prolongation
of coagulation time, gastrointestinal
haemorrhages, subcutaneous hematomas.
These symptoms might be explained by
the deficiency of the following vitamin:
A. K
B. B1
C. B6
D. H
E. E
65. A patient suffering from chronic
cardiac insufficiency was recommended
to undergo a prophylactic course of
treatment with a cardiological drug from
the group of cardiac glycosides that is
to be taken enterally. What drug was
recommended?
 Krok 1 Medicine 2010
A. Digoxin
B. Strophanthine
C. Corglycon
D. Cordiamin
E. Cordarone
66. A cerebral trauma caused increased
ammonia generation. What amino acid
participates in the excretion of ammonia
from the cerebral tissue?
A. Glutamic
B. Tyrosine
C. Valine
D. Tryptophan
E. Lysine
67. During the repeated Widal’s aggluti-
nation test it was noticed that the ratio
of antibody titers and O-antigens S.typhi
in the patient’s serum had increased from
1:100 to 1:400. How would you interpret
these results?
A. The patient has typhoid fever
B. The patient is an acute carrier of typhoid
microbes
C. The patient is a chronic carrier of
typhoid microbs
D. The patient previously had typhoid
fever
E. The patient was previously vaccinated
against typhoid fever
68. It is known that the gene responsible
for development of blood groups accordi-
ng to AB0 system has three allele vari-
ants. If a man has IV blood group, it can
be explained by the following variability
form:
A. Combinative
B. Mutational
C. Phenotypic
D. Genocopy
E. Phenocopy
69. 48 hours after tuberculine test
(Mantoux test) a child had a papule 10
mm in diameter on the spot of tuberculine
injection. What hypersensitivity mechani-
sm underlies these changes?
A. Cellular cytotoxicity
B. Anaphylaxy
C. Antibody-dependent cytotoxicity
D. Immunocomplex cytotoxicity
E. Granulomatosis
70. Examination of a newborn boy’s geni-
talia revealed an urethral hiatus that
opens on the undersite of his penis. What
malformation is it?
8
A. Hypospadias
B. Hermaphroditism
C. Epispadia
D. Monorchism
E. Cryptorhidism
71. A patient complains about impaired
evacuatory function of stomach (long-
term retention of food in stomach).
Examination revealed a tumour of initi-
al part of duodenum. Specify localization
of the tumour:
A. Pars superior
B. Pars inferior
C. Pars descendens
D. Pars ascendens
E. Flexura duodeni inferior
72. A concentrated solution of sodium
chloride was intravenously injected to an
animal. This caused decreased reabsorpti-
on of sodium ions in the renal tubules. It
is the result of the following changes of
hormonal secretion:
A. Aldosterone reduction
B. Aldosterone increase
C. Vasopressin reduction
D. Vasopressin increase
E. Reduction of atrial natriuretic factor
73. People adapted to high external
temperatures have such pecularity:
profuse sweating isn’t accompanied by
loss of large volumes of sodium chloride.
This is caused by the effect of the followi-
ng hormone upon the perspiratory glands:
A. Aldosterone
B. Vasopressin
C. Cortisol
D. Tgyroxin
E. Natriuretic
74. Emotional stress causes activation of
hormon-sensitive triglyceride lipase in
the adipocytes. What secondary mediator
takes part in this process?
A. Cyclic adenosine monophosphate
B. Cyclic guanosine monophosphate
C. Adenosine monophosphate
D. Diacylglycerol
E. Ions of 2+
75. A patient has been syffering from
diarrhea for 5 day. On the fith day
colonoscopy revealed that membrane
of rectum was inflamed, there were
greyish-green films closely adhering to
the subjacent tissue. What is the most
 Krok 1 Medicine 2010 9

probable diagnosis? 80. A 42 year old woman with neuralgia

of trifacial nerve complains about peri-
A. Dysentery odical reddening of the right part of her
B. Typhoid fever face and neck, sense of warmth gush,
C. Nonspecific ulcerous colitis increased skin sensitivity. These effects
D. Salmonellosis can be explained by the following type
E. Crohn’s disease of arterial hyperemia:
76. A 17 year old boy fell seriously ill, A. Neurotonic
the body temperature rose up to 38, 5oC, B. Neuroparalytic
there appeared cough, rhinitis, lacrimati- C. Metabolic
on, nasal discharges. What inflammation D. Functional
is it? E. Reactive
A. Catarrhal 81. A 30 year old woman has face
B. Serous edemata. Examination revealed protei-
C. Fibrinous nuria (5,87 g/l), hypoproteinemia,
D. Purulent dysproteinemia, hyperlipidemia. What
E. Hemorrhagic condition is the set of these symptoms
typical for?
77. A 25 year old Palestinian woman
complains of weakness, dizziness, A. Nephrotic syndrome
dyspnea. In anamnesis: periodically B. Nephritic syndrome
exacerbating anemia. In blood: Hb - 60 C. Chronic pyelonephritis
g/l, erythrocytes - 2, 5 · 1012 /l, reticulocytes D. Acute renal failure
- 35o /oo , anisocytosis and poikilocytosis E. Chronic renal failure
of erythrocytes, a lot of target cells and
polychromatophils. What type of anemia 82. Autopsy of a 17 year old girl who
is it? died from pulmonary failure revealed
a small area of caseous necrosis in the
A. Thalassemia inferior lobe of the right lung, and
B. Sickle-cell anemia occurences of caseous necrosis in the
C. Minkowsky-Shauffard disease bronchopulmonary, bronchial and bi-
D. Addison-Biermer disease furcational lymph nodes. What is the most
E. Glucose 6-phosphate dehydrogenase- probable postmortem diagnosis?
deficient anemia
A. Primary tuberculosis
78. A patient suffering from initial B. Hematogenous progression of primary
hypertension has been taking an anti- tuberculosis
hypertensive preparation for a long ti- C. Hematogenous tuberculosis with
me. Suddenly he stopped taking this predominant lung affection
preparation. After this his condition D. Tuberculoma
grew worse, this led to development of E. Caseous pneumonia under secondary
hypertensive crisis. This by-effect can be tuberculosis
classified as:
83. A patient has a decreased vasopressin
A. Abstinence syndrome synthesis that causes polyuria and as a
B. Cumulation result of it evident organism dehydratati-
C. Tolerance on. What is the mechanism of polyuria
D. Sensibilization development?
E. Dependence
A. Reduced tubular reabsorption of water
79. Inflammatory processes cause B. Reduced tubular reabsorption of Na
synthesis of protein of acute phase in ions
an organism. What substances stumulate C. Reduced tubular reabsorption of
their synthesis? protein
D. Reduced glucose reabsorption
A. Interleukin-1 E. Acceleration of glomerular filtration
B. Immunoglobulins
C. Interferons 84. A 35 year old man consulted a denti-
D. Biogenic amins st about reduced density of dental ti-
E. Angiotensin ssue, high fragility of teeth during eati-
ng solid food. This patient suffers the
 Krok 1 Medicine 2010
most probably from the deficiency of the
following mineral element:
A. Calcium
B. Potassium
C. Sodium
D. Magnesium
E. Iron
85. A patient staying in the pulmonologi-
cal department was diagnosed with
pulmonary emphysema accompanied by
reduced elasticity of pulmonary tissue.
What type of respiration is observed?
A. Expiratory dyspnea
B. Inspiratory dyspnea
C. Superficial respiration
D. Infrequent respiration
E. Periodic respiration
86. A 4 year old child complained of
pain during deglutition, indisposition.
Objectively: palatine arches and tonsils
are moderately edematic and hyperemic,
there are greyish-white films up to 1 mm
thick closely adhering to the subjacent ti-
ssues. What pathological process are these
changes typical for?
A. Inflammation
B. Dystrophy
C. Necrosis
D. Metaplasia
E. Organization
87. An unconscious young man with signs
of morphine poisoning entered admissi-
on office. His respiration is shallow and
infrequent which is caused by inhibition
of respiratory centre. What type of respi-
ratory failure is it?
A. Ventilative dysregulatory
B. Ventilative obstructive
C. Ventilative restrictive
D. Perfusive
E. Diffusive
88. A patient with cholelithiasis fell
ill with mechanic jaundice. Examinati-
on revealed that the stone was in the
common bile duct. What bile-excreting
ducts make up the obturated duct?
10
A. Ductus hepaticus communis et ductus
cysticus
B. Ductus hepaticus dexter et sinister
C. Ductus hepaticus dexter et ductus
cysticus
D. Ductus hepaticus sinister et ductus
cysticus
E. Ductus hepaticus communis et ductus
choledochus
89. A patient is 44 years old. Laboratory
examination of his blood revealed that
content of proteins in plasma was 40 g/l.
What influence will be exerted on the
transcapillary water exchange?
A. Filtration will be increased, reabsorpti-
on - decreased
B. Both filtration and reabsorption will be
increased
C. Both filtration and reabsorption will be
decreased
D. Filtration will be decreased, reabsorpti-
on - increased
E. Exchange will stay unchanged
90. After destruction of CNS structures
an animal lost orientative reflexes. What
structure was destroyed?
A. Quadrigeminal plate
B. Red nucleus
C. Lateral vestibular nuclei
D. Black substance
E. Medial reticular nuclei
91. An isolated cell of human heart
automatically generates excitement
impulses with frequency of 60 times per
minute. This cell was taken from the
following heart structure:
A. Sinoatrial node
B. Atrium
C. Ventricle
D. Atrioventricular node
E. His’ bundle
92. A 62 year old patient who previ-
ously worked as stoker was admitted to
a hospital with complaints about general
weakness, abrupt weight loss, hoarse voi-
ce, dyspnea, dry cough. Laryngoscopy
revealed a tumour in the pharynx that
invaded vocal cords and epiglottis. What
is the most probable cause of tumour
development?
 Krok 1 Medicine 2010
A. Polycyclic aromatic carbohydrates
B. Nitrosamines
C. Aromatic amines and amides
D. Retroviruses
E. Ionizing radiation
93. Examination of a man who had been
working hard under higher temperature
of the environment revealed abnormal
quantity of blood plasma proteins. What
phenomenon is the case?
A. Relative hyperproteinemia
B. Absolute hyperproteinemia
C. Absolute hypoproteinemia
D. Dysproteinemia
E. Paraproteinemia
94. A patient ill with thrombophlebitis of
his lower limbs had chest pain, blood spi-
tting, progressing respiratory insufficiency
that led to his death. Autopsy diagnosed
multiple lung infarctions. What is the most
probable cause of their development?
A. Thromboembolism of pulmonary artery
branches
B. Thrombosis of pulmonary artery
branches
C. Thrombosis of bronchial arteries
D. Thromboembolism of bronchial arteries
E. Thrombosis of pulmonary veins
95. During influenza epidemic 40% of
pupils who didn’t go in for sports were
affected by the disease, and among the
pupils who regularly did physical exercises
this index was only 20%. What adaptati-
ve mechanisms determined such a low si-
ckness rate of pupils participating in the
sports?
A. Cross adaptation
B. Specific adaptation
C. Physiological adaptation
D. Biochemical adaptation
E. Genetic adaptation
96. A patient suffers from stenocardia
and takes isosorbide mononitrate. He was
prescribed a complementary drug with di-
saggregating effect. What drug is it?
A. Acetylsalicinic acid
B. Nitroglycerine
C. Propranolol
D. Nifedipine
E. Validol
97. A patient in postoperative period was
prescribed an anticholinesterase drug for
stimulation of intestinal peristalsis and
tonus of urinary bladder. What drug is it?
11
A. Proserin
B. Dichlothiazide
C. Reserpine
D. Mannitol
E. Propanolol
98. A patient has acne on his face. Mi-
crospcopic examination of scrapings from
the affected areas revealed living porrect
vermiform arthropoda 0,2-0,5 mm large
with four pairs of short extremities in the
front part of their bodies. What is the
laboratory diagnosis?
A. Demodicosis
B. Scabies
C. Myiasis
D. Pediculosis
E. Phthiriasis
99. Among junior children of an
orphanage an outbreak of intestinal
infection with signs of colienteritis was
registered. In order to identify isolated
causative agent it is necessary to:
A. Study antigenic properties of the
causative agent
B. To determine sensitivity to antibiotics
C. To study sensitivity to bacteriophages
D. To study biochemical properties of the
causative agent
E. To study virulence of the causative agent
100. A 45 year old man consulted a doctor
about a plaque-like formation on his neck.
Histological examination of a skin bi-
optate revealed clusters of round and
oval tumour cells with a narrow border of
basophilic cytoplasm resembling of cells
of basal epidermal layer. What tumour is
it?
A. Basal cell carcinoma
B. Epidermal cancer
C. Hydroadenoma
D. Trichoepithelioma
E. Syringoadenoma
101. 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?
A. Atrioventricular
B. Sinus
C. Atrial
D. Ventricular
E. Bundle-branch
 Krok 1 Medicine 2010 12

102. A virological laboratory obtained 106. Hepatitis has led to the development
pathological material (mucous discharges of hepatic failure. Mechanism of edemata
from nasal meatuses) taken from a pati- formation is activated by the impairment
ent with provisional diagnosis "influenza". of the following liver function:
What quick test will allow to reveal speci-
fic viral antigen in the material under A. Protein-synthetic
examination? B. Barrier
C. Chologenetic
A. Direct and indirect D. Antitoxic
immunofluorescence test E. Glycogen-synthetic
B. Direct and indirect fluorescence
immunoassay 107. A patient working at a pig farm
C. Hemagglutination inhibition assay complains about paroxysmal abdomi-
D. Radioimmunoassay nal pain, liquid feces with admixtures of
E. - mucus and blood, headache, weakness,
fever. Examination of large intestine
103. A family of students who came revealed ulcers from 1 mm up to several
from Africa got a child with anemia si- cm large, feces contained oval unicellular
gns. The child died soon. Examinati- organisms with cilia. What disease should
on revealed that the child’s erythrocytes be suspected?
have abnormal semilunar shape. Specify
genotypes of the child’s parents: A. Balantidiasis
B. Amebiasis
A. Аа х Аа C. Toxoplasmosis
B. Аа х аа D. Lambliasis
C. АА х АА E. Trichomoniasis
D. аа х аа
E. Аа х АА 108. A patient staggers and walks
astraddle. He has hypomyotonia of arm
104. Two hours after an exam a student and leg muscles, staccato speech. In what
had a blood count done and it was brain section is this affection localized?
revealed that he had leukocytosis wi-
thout significant leukogram modifications. A. Cerebellum
What is the most probable mechanism of B. Putamen
leukocytosis development? C. Caudate nucleus
D. Motor cortex
A. Redistribution of leukocytes in the E. Red nucleus
organism
B. Leukopoiesis intensification 109. During hypersensitivity test a patient
C. Deceleration of leukocyte lysis got subcutaneous injection of an antigen
D. Deceleration of leukocyte migration to which caused reddening of skin, edema,
the tissues pain as a result of histamine action. This
E. Leukopoiesis intensification and biogenic amine is generated as a result of
deceleration of leukocyte lysis transformation of the following histidine
amino acid:
105. A 66 year old female patient
got intravenous injection of magnesi- A. Decarboxylation
um sulfate solution for the purpose of B. Methylation
elimination of hypertensive crisis. But C. Phosphorylation
arterial pressure didn’t go down and D. Isomerization
after repeated introduction of the same E. Deaminization
preparation there appered sluggishness, 110. Normal, actively dividing cells of
slow response, inhibition of consciousness human red bone marrow are analyzed.
and respiration. What preparation is What number of cells’ chromosomes is
antagonist of magnesium sulfate and can typical for G1 period?
eliminate symptoms of its overdose?
A. 46
A. Calcium chloride B. 48
B. Potassium chloride C. 47
C. Sodium chloride D. 45
D. Activated carbon E. 23
E. Potassium permanganate
 Krok 1 Medicine 2010
111. Blood group of a 30 year old man was
specified before an operation. His blood
is Rh-positive. Reaction of erythrocyte
agglutination was absent with standard
sera of 0αβ (I), Аβ (II), Вα (III) groups.
The blood under examination is of the
following group:
A. 0αβ (I)
B. Аβ (II)
C. Вα (III)
D. АВ (IV)
E. -
112. A 64 year old woman has impairment
of twilight vision (hemeralopy). What vi-
tamin should be recommended in the first
place?
A. Vitamin A
B. Vitamin B2
C. Vitamin E
D. Vitamin C
E. Vitamin B6
113. A patient underwent appendectomy.
In the postoperative period he has been
taking an antibiotic. The patient complai-
ns about hearing impairment and vesti-
bular disorders. What group of antibiotics
has such by-effects?
A. Aminoglycosides
B. Penicillins
C. Tetracyclines
D. Macrolides
E. Cephalosporins
114. A patient was stung by a bee. Exami-
nation revealed that his left hand was hot,
pink, edematic, there was a big red blister
on the site of sting. What is the leading
mechanism of edema development?
A. Increased vessel permeability
B. Reduced vessel filling
C. Injury of vessels caused by the sting
D. Drop of oncotic pressure in tissue
E. Drop of osmotic pressure in tissue
115. A patient complained about di-
zziness, memory impairment, periodical
convulsions. It was revealed that these
changes were caused by a product of
decarboxylation of glutamic acid. Name
this product:
A. GABA
B. Pyridoxal phosphate
C. TDP
D. ATP
E. THFA
13
116. A sportsman needs to improve his
sporting results. He was recommended to
take a preparation that contains carnitine.
What process is activated the most by this
compound?
A. Fatty acids transporting
B. Amino acids transporting
C. Calcium ions transporting
D. Glucose transporting
E. Vitamin K transporting
117. Laboratory examination of a child
revealed increased concentration of leuci-
ne, valine, isoleucine and their ketoderi-
vatives 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
acids
B. Aminotransferase
C. Glucose-6-phosphatase
D. Phosphofructokinase
E. Phosphofructomutase
118. A 7 year old child often suffers from
streprococcic angina. Doctor suspected
development of rheumatism and admini-
stered serological examination. The provi-
sional diagnosis will be most probably
confirmed by presence of antibodies to
the following streptococcic antigen:
A. O-streptolysin
B. C-carbohydrate
C. M-protein
D. Erythrogenic toxin
E. Capsular polysaccharide
119. A 46 year old patient who had been
suffering from tuberculosis for 6 years di-
ed from massive pulmonary haemorrhage.
Autopsy revealed different-sixed foci of
sclerosis and caseous necrosis in lungs, in
the upper part of the right lung there was
a cavity 5 cm in diameter with dense grey
walls, the cavity contained liquid blood
and blood clots. What type of tuberculosis
is it?
A. Fibrocavernous
B. Acute cavernous
C. Infiltrative
D. Fibrous focal
E. Acute focal
120. A patient suffering from pheochromocytoma
complains of thirst, dry mouth,
hunger. Blood test for sugar revealed
hyperglycemia. What type of hyperglycemia
is it?
 Krok 1 Medicine 2010
A. Adrenal
B. Hypercorticoid
C. Alimentary
D. Somatotropic
E. Hypoinsulinemic
121. A patient has been suffering from
elevated temperature and attacks of typi-
cal cough for 10 days. Doctor admini-
stered inoculation of mucus from the pati-
ent’s nasopharynx on the agar. What mi-
croorganism is presumed?
A. Pertussis bacillus
B. Pfeiffer’s bacillus
C. Listeria
D. Klebsiella
E. Staphylococcus
122. A patient suffering from stenocardia
was taking nitroglycerine which caused
restoration of blood supply of myocardi-
um and relieved pain in the cardiac area.
What intracellular mechanism provides
restoration of energy supply of insulted
cells?
A. Intensification of ATP resynthesis
B. Reduction of ATP resynthesis
C. Increased permeability of membranes
D. Intensification of oxygen transporting
into the cell
E. Intensification of RNA generation
123. A 50 year old patient has been taki-
ng 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
tumour-like formations, cysts. Bony tissue
was substituted by fibrous connective ti-
ssue. Examination revealed also adenoma
of parathyroid gland and hypercalcemia.
What is the most probable diagnosis?
A. Parathyroid osteodystrophy
B. Myelomatosis
C. Osteomyelitis
D. Osteopetrosis
E. Paget’s disease
124. A couple had a child with Down’s di-
sease. Mother is 42 years old. This disease
is most probably caused by the following
impairment of prenatal development:
A. Gametopathy
B. Blastopathy
C. Embryopathy
D. Non-specific fetopathy
E. Specific fetopathy
14
125. A man weighs 80 kg, after long physi-
cal activity his circulating blood volume is
reduced down to 5,4 l, hematocrit makes
up 50%, whole blood protein is 80 g/l.
These blood characteristics are determi-
ned first of all by:
A. Water loss with sweat
B. Increased number of erythrocytes
C. Increased protein concentration in
plasm
D. Increased circulating blood volume
E. Increased diuresis
126. Examination of a pregnant woman
revealed twice as much concentration of
fibrinogen in blood plasm. What ESR can
this woman have?
A. 40-50 mm/h
B. 10-15 mm/h
C. 2-12 mm/h
D. 5-10 mm/h
E. 0-5 mm/h
127. Examination of a child who
frequently suffers from infectious diseases
revealed that IgG concentration in blood
serum was 10 times less than normal, IgA
and IgM concentration was also signifi-
cantly reduced. Analysis showed also lack
of B-lymphocytes and plasmocytes. What
disease are these symptoms typical for?
A. Bruton’s disease
B. Swiss-type agammaglobulinemia
C. Dysimmunoglobulinemia
D. Louis-Bar syndrome
E. Di George syndrome
128. Introduction of a big dose of hi-
stamine to an experimental animal caused
abrupt drop of arterial pressure as a result
of:
A. Dilatation of resistance vessels
B. Constriction of resistance vessels
C. Increase of heart rate
D. Decrease of heart rate
E. Decrease of heart rate and force
129. Examination of a 42 year old patient
revealed a tumour of adenohypophysis.
Objectively: the patient’s weight is 117
kg, he has moon-like hyperemic face, red-
blue striae of skin distension on his belly.
Osteoporosis and muscle dystrophy are
present. AP is 210/140 mm Hg. What is
the most probable diagnosis?
 Krok 1 Medicine 2010 15

A. Cushing’s disease
B. Cushing’s syndrome A. Levodopa
C. Conn’s disease B. Diphenylhydantoin
D. Diabetes mellitus C. Phenobarbital
E. Essential hypertension D. Diazepam
E. Ethosuximide
130. Vagus branches that innervate heart
are being stimulated during an experi- 135. Examination of a patient with
ment. This caused reduction of heart rate impaired blood coagulation revealed
due to the intensification of the followi- thrombosis of a branch of inferior
ng process (through the cell membrane of mesenteric artery. What bowel segment
cardiac pacemaker): is damaged?
A. Potassium ion yield A. Colon sigmoideum
B. Potassium ion entry B. Ileum
C. Calcium ion entry C. Caecum
D. Calcium ion yield D. Colon transversum
E. Calcium and potassium ion yield E. Colon ascendens
131. A patient got an injury of spinal 136. When blood circulation in the
marrow in a road accident that caused damaged tissue is restored, then lactate
loss of tactile sensation, posture sense, vi- accumulation comes to a stop and
bration sense. What conduction tracts are glucose consumption decelerates. These
damaged? metabolic changes are caused by activati-
on of the following process:
A. Fascicle of Goll and cuneate fascicle
B. Anterior spinocerebellar tract A. Aerobic glycolysis
C. Rubrospinal tract B. Anaerobic glycolysis
D. Reticulospinal tract C. Lipolysis
E. Tectospinal tract D. Gluconeogenesis
E. Glycogen biosynthesis
132. A scheme presents an exocrinous
gland that has unbranched excretory duct 137. A woman was delivered to a hospi-
with a terminal part in form of a saccule tal for trachea intubation. What of the
openining into the duct. How is this gland following drugs should be applied in this
called according to the morphological case?
classification of exocrinous glands?
A. Dithylinum
A. Simple unbranched alveolar B. Nitroglycerine
B. Compound branched alveolar C. Metronidazole
C. Simple branched tubular D. Atropine sulfate
D. Compound unbranched alveolar E. Gentamycin sulfate
E. Compound unbranched alveolar tubular
138. A patient suffers from pulmonary
133. Examination of a patient revealed tuberculosis. During treatment neuritis of
hypertrophy and inflammation of visual nerve arose. What drug has caused
lymphoid tissue, edema of mucous this by-effect?
membrane between palatine arches (acute
A. Isoniazid
tonsillitis). What tonsil is normally si- B. Ethambutol
tuated in this area? C. Kanamycin
A. Tonsilla palatina D. Rifampicin
B. Tonsilla pharyngealis E. Streptomycin
C. Tonsilla tubaria 139. A patient suffers from chronic left-
D. Tonsilla lingualis ventricular insufficiency. What medication
E. - should be administered?
134. A patient complained about muscle A. Digoxin
rigidity, constrained motions, constant B. Bemegride
tremor of arms. On the grounds of exami- C. Etimizole
nation his disease was diagnosed as Parki- D. Vinpocetine
nson’s disease. What drug should be admi- E. Pyracetam
nistered?
 Krok 1 Medicine 2010
140. Roentgenological examination of
skull base bones revealed enlargement of
sellar cavity, thinning of anterior clinoid
processes, destruction of different parts,
destruction of different parts of sella turci-
ca. Such bone destruction might be caused
by a tumour of the following wndocrinous
gland:
A. Hypophysis
B. Epiphysis
C. Thymus gland
D. Adrenal glands
E. Thyroid gland
141. Patients who suffer from severe di-
abetes and don’t receive insulin have
metabolic acidosis. This is caused by
increased concentration of the following
metabolites:
A. Ketone bodies
B. Fatty acids
C. Unsaturated fatty acids
D. Triacylglycerols
E. Cholesterol
142. 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?
A. Impaired synthesis of calcitriol
B. Increased excretion of calcium
C. Hyperfunction of parathyroid glands
D. Hypofunction of parathyroid glands
E. Lack of calcium in food
143. A man was intoxicated with
mushrooms. They contain muscarine that
stimulates muscarinic cholinoreceptors.
What symptoms signalize intoxication wi-
th inedible mushrooms?
A. Myotic pupils
B. Mydriatic pupils
C. Bronchi dilatation
D. Increased heart rate
E. Rise of arterial pressure
144. A 47 year old man with myocardi-
um infarction was admitted to the cardi-
ological department. What changes of
cellular composition of peripheral blood
are induced by necrotic changes in the
myocardium?
A. Neutrophilic leukocytosis
B. Monocytosis
C. Eosinophilic leukocytosis
D. Thrombocytopenia
E. Lymphopenia
16
145. A patient with skin mycosis has di-
sorder of cellular immunity. The most
typical characteristic of it is reduction of
the following index:
A. T-lymphocytes
B. Immunoglobulin G
C. Immunoglobulin E
D. B-lymphocytes
E. Plasmocytes
146. A 50 year old patient underwent
resection of tumour of large intestine
wall. Microscopically it presents itself as
fascicles of divergent collagen fibers of
different thickness and form and some
monomorphous fusiform cells that are
irregularly distributed among the fibers.
Cellular atypia is not evident. What
tumour is it?
A. Hard fibroma
B. Fibromyoma
C. Soft fibroma
D. Desmoma
E. Fibrosarcoma
147. A cell at the stage of mitosis anaphase
was stimulated by colchicine that inhibi-
ts chromosome separation to the poles.
What type of mutation will be caused?
A. Polyploidy
B. Inversion
C. Deletion
D. Duplication
E. Translocation
148. Autopsy of a 5 year old child revealed
in the area of vermis of cerebellum a
soft greyish-pink node 2 cm in diameter
with areas of haemorrhage. Histologi-
cally this tumour consisted of atypical
monomorphous small roundish cells wi-
th big polymorphous nuclei. What tumour
is it?
A. Medulloblastoma
B. Meningioma
C. Glioblastoma
D. Astrocytoma
E. Oligodendroglioma
149. Voluntary breath-holding caused
increase of respiration depth and
frequency. The main factor stimulating
these changes of external respiration is:
 Krok 1 Medicine 2010
A. Increased tension of CO2 in blood
B. Increased tension of O2 in blood
C. Decreased tension of O2 in blood
D. Decreased tension of CO2 in blood
E. Decreased concentration of H + in blood
150. A patient was admitted to the surgi-
cal department with inguinal hernia. Duri-
ng the operation the surgeon performs
plastic surgery on posterior wall of ingui-
nal canal. What structure forms this wall?
A. Transverse fascia
B. Aponeurosis of abdominal external
oblique muscle
C. Inguinal ligament
D. Loose inferior edge of transverse
abdominal muscle
E. Peritoneum
151. A patient has delayed conduction
of excitement through the atrioventri-
cular node. What changes of ECG will
be observed?
A. Prolongation of P − Q interval
B. Prolongation of Q − S interval
C. Negative T wave
D. S − T -segment displacement
E. Prolongation of Q − T interval
152. Surface with an intact toad on it was
inclined to the right. Tone of extensor
muscles became reflectory higher due to
the activation of the following receptors:
A. Vestibuloreceptors of utricle and
saccule
B. Vestibuloreceptors of semicircular ducts
C. Mechanoreceptors of foot skin
D. Photoreceptors of retina
E. Proprioreceptors
153. A female patient underwent liver
transplantation. 1,5 month after it her
condition became worse because of reacti-
on of transplant rejection. What factor of
immune system plays the leading part in
this reaction?
A. T-killers
B. Interleukin-1
C. Natural killers
D. B-lymphocytes
E. T-helpers
154. Microscopical examination of a mi-
crobal culture revealed fusiform spore-
forming microorganisms that get violet-
blue Gram’s stain. What microorganisms
were revealed?
17
A. Clostridia
B. Streptococci
C. Spirochaete
D. Actinomycete
E. Diplococci
155. A bacteriological laboratory received
sputum sample of a patient suffering from
tuberculosis. Bacterioscopic examination
of smears and detection of tuberculosis
bacillus can be realized by one of enri-
chment methods that involves processing
of sputum only with solution of caustic
soda. What is this method called?
A. Homogenization
B. Inactivation
C. Flotation
D. Filtration
E. Neutralization
156. Electronic microphotography of
pulmonary alveole’s wall presents a big
cell. Its cytoplasm has a lot of mi-
tochondria, developed Golgi apparatus,
osmiophil lamellated corpuscles. What is
the main function of this cell?
A. It produces surfactant
B. It is a component of blood-air barrier
C. It warms the air
D. It purifies the air
E. It absorbs microorganisms
157. A patient in a transplantation centre
underwent heart transplantation. The
organ was taken from a donor who di-
ed in a road accident. Foreign heart can
be rejected as a result of development
of transplantation immunity. It is usually
prevented by means of:
A. Immunosuppressors
B. Chemotherapy
C. Ultrasound
D. Enzymes
E. X-ray therapy
158. A child is pale, pastose, muscular ti-
ssue is bad developed, lymph nodes are
enlarged. He often suffers from angi-
na and pharyngitis, blood has signs of
lymphocytosis. The child is also predi-
sposed to autoallergic diseases. What type
of diathesis can be presumed in this case?
A. Lymphohypoplastic
B. Exudative
C. Gouty
D. Asthenic
E. Hemorrhagic
159. A patient had been suffering from
 Krok 1 Medicine 2010
profuse diarrhea and vomiting for 2 days.
He died from acute dehydration. Autopsy
revealed that the intestinal wall was
edematic and hyperemic, with multiple
haemorrhages in the mucous membrane.
Intestine lumen contains whitish fluid
resembling of rice water. What disease
caused death?
A. Cholera
B. Dysentery
C. Salmonellosis
D. Typhoid fever
E. Enterocolitis
160. Examination of a 66 year old
patient revealed a lytic tumour in the
locus of pathological rib fracture. Hi-
stologically this tumour consists of atypi-
cal plasmoblasts. Further examinati-
on revealed osteoporosis in the bones
of vertebral column and pelvis. These
changes are typical for:
A. Myelomatosis
B. Tuberculous osteomyelitis
C. Ewing’s osteosarcoma
D. Neuroblastoma
E. Metastatic lung cancer
161. A patient died from acute cardiac
insufficiency, among clinical presentations
there was gastrointestinal haemorrhage.
Examination of mucous membrane of
sromach revealed some defects reachi-
ng myenteron; their edges and bottom
were mostly even and loose, some of
them contained dark-red blood. What
pathological process was revealed?
A. Acute ulcers
B. Chronic ulcers
C. Erosions
D. Thrombosis
E. Inflammation
162. A 33 year old man died from uraemia.
Autopsy revealed enlarged kidneys wei-
ghing 500,0 each and consisting of multi-
ple cavities 0,5-2 cm in diameter. The cavi-
ties were full of light-yellow transparent
liquid. Renal pelvis and ureters had no
pecularities. What renal disease caused
uraemia?
A. Bilateral polycystic renal disease
B. Chronic pyelonephritis
C. Renal tumour
D. Renal tuberculosis
E. Rapidly progressing glomerulonephritis
163. A patient got a trauma that caused
dysfunction of motor centres regulating
18
activity of head muscles. In what parts
of cerebral cortex is the respective centre
normally localized?
A. Inferior part of precentral gyrus
B. Superior part of precentral gyrus
C. Supramarginal gyrus
D. Superior parietal lobule
E. Angular gyrus
164. Material taken from a patient wi-
th provisional diagnosis "influenza"was
referred to a laboratory. For virological
examination the hemadsorption reaction
was applied. This reaction can be applied
for detection of the following viruses:
A. Viruses containing hemagglutinins
B. All the simple viruses
C. All the complex viruses
D. DNA-genomic viruses
E. Any viruses
165. Lungs of a preterm infant have areas
of atelectasis (pulmonary collapse). The
main cause is:
A. Surfactant deficiency
B. Increased viscous resistance
C. Underdeveloped inspiration muscles
D. Diminished force of surface tension of
lungs
E. Surfactant excess
166. An alcoholic woman has born a girl
with mental and physical developmental
lag. Doctors diagnosed the girl with fetal
alcohol syndrome. What effect is the cause
of the girl’s state?
A. Teratogenic
B. Mutagenic
C. Malignization
D. Carcinogenic
E. Mechanic
167. A viral infection has damaged cells
that form walls of bile capillaries. This sti-
mulated conditions for inflow of bile into
the blood of sinusoidal capillaries. What
cells are damaged?
A. Hepatocytes
B. Kupffer’s cells
C. Ito cells
D. Pit-cells
E. Endotheliocytes
168. Dietary intake of a 30 year old nursi-
ng woman contains 1000 mg of calcium,
1300 mg of phosphorus and 20 mg of iron
per day. It is necessary to change content
of these mineral substances in the followi-
 Krok 1 Medicine 2010
ng way:
A. To increase phosphorus content
B. To increase calcium content
C. To reduce fluorine content
D. To increase iron content
E. To reduce iron content
169. A patient with obliterating
atherosclerosis underwent sympathectomy
of femoral artery in the region of femoral
trigone. What type of arterial hyperemia
was induced by the operation?
A. Neuroparalytic
B. Reactive
C. Metabolic
D. Neurotonic
E. Functional
170. A 15 year old girl has pale skin, glossi-
tis, gingivitis. Blood count: erythrocytes -
3, 3 cot 1012 /l, hemoglobin - 70 g/l, colour
index - 0,5. Examination of blood smear
revealed hypochromia, microcytosis, poi-
kilocytosis. What type of anemia is it?
A. Iron-deficient
B. B12 -folic acid-deficient
C. Sickle-cell
D. Hemolytic
E. Thalassemia
171. Burned skin surface was treated wi-
th a certain preparation. Its antiseptic
properties are provided by atomic oxygen
that is formed in presence of organic
substances. What preparation was appli-
ed?
A. Potassium permanganate
B. Furacillin
C. Chlorhexidine bigluconate
D. Alcoholic iodine solution
E. Sodium hydrocarbonate
172. Cardinal symptoms of primary
hyperparathyroidism are osteoporosis and
renal lesion along with development of
urolithiasis. What substance makes up the
basis of these calculi in this disease?
A. Calcium phosphate
B. Uric acid
C. Cystine
D. Bilirubin
E. Cholesterol
173. A patient with chronic cardiac insuffi-
ciency has been taking foxglove (Digi-
talis) preparations for a long time. Due
to the violation of intake schedule the
woman got symptoms of intoxication.
19
These symptoms result from:
A. Material cumulation
B. Tachyphylaxis
C. Idiosyncrasy
D. Antagonism
E. Sensibilization
174. A patient was diagnosed wi-
th paralysis of facial and masticatory
muscles. The haematoma is inside the
genu of internal capsule. What conduction
tract is damaged?
A. Tr. cortico-nuclearis
B. Tr. cortico-spinalis
C. Tr. cortico-thalamicus
D. Tr. cortico-fronto-pontinus
E. Tr. cortico-temporo-parieto-occipito-
pontinus
175. A 5 year old child is ill with measles.
Blood analysis revealed increase of total
number of leukocytes up to 13 · 109 /l.
Leukogram: basophils - 0, eosinophils
- 1, myelocytes - 0, juvenile neutrophi-
ls - 0, band neutrophils - 2, segmented
neutrophils - 41, lymphocytes - 28,
monocytes - 28. Name this phenomenon:
A. Monocytosis
B. Agranulocytosis
C. Lymphocytosis
D. Eosinopenia
E. Neutropenia
176. A patient was admitted to the infecti-
ous department. His symptoms: dry skin,
decreased skin turgor, rice-water stool.
The patient was diagnosed with cholera.
What disorder of water-electrolytic
balance is most often observed in this di-
sease?
A. Isoosmotic hypohydration
B. Hyperosmotic hyperhydration
C. Hypoosmotic hypohydration
D. Hyperosmotic hypohydration
E. Hypoosmotic hyperhydration
177. A foreign body (a button) closed
space of the right superior lobar bronchus.
What segments of the right lung won’t be
supplied with air?
A. Apical, posterior, anterior
B. Superior and inferior lingular
C. Apical and posterior basal
D. Apical and median basal
E. Medial and lateral
178. A patient was diagnosed with
bartholinitis (inflammation of greater
 Krok 1 Medicine 2010 20

vulvovaginal glands). In which organ of tis, cellular infiltration composed of

urogenital system are these glands locali- lymphocytes, epithelioid cells (mainly
zed? plasmocytes). What is the most probable
diagnosis?
A. Large lips of pudendum
B. Small lips of pudendum A. Syphilis
C. Clitoris B. Tuberculosis
D. Vagina C. Scleroma
E. Uterus D. Sarcoma
E. Leprosy
179. A histological specimen presents an
artery. One of the membranes of its wall 184. A young woman who entered a
has flat cells lying on the basal membrane. production department where it strongly
What type of cells is it? smelt of paints and varnishes had a
bronchospasm. This reflex was caused by
A. Endothelium irritation of the following receptors:
B. Mesothelium
C. Smooth myocytes A. Irritant
D. Fibroblasts B. Juxtaglomerular
E. Macrophages C. Pleura receptors
D. Central chemoreceptors
180. Study of conversion of a food colouri- E. Peripheral chemoreceptors
ng agent revealed that neutralization of
this xenobiotic takes place only in one 185. A 50 year old man who was referred
phase - microsomal oxydation. Name a to the hospital for treatment of cervical
component of this phase: lymphadenitis underwent test for induvi-
dual sensitivity to penicillin. 30 seconds
A. Cytochrome Р-450 after he went hot all over, AP dropped
B. Cytochrome B down to 0 mm Hg that led to cardiac
C. Cytochrome C arrest. Resuscitation was unsuccessful.
D. Cytochrome A Autopsy results: acute venous plethora
E. Cytochrome oxidase of internal organs; histological examinati-
181. Ultrasonic examination of a patient on of skin (from the site of injection)
revealed aneurism in the area of aortic revealed degranulation of mast cells (ti-
arch that caused alteration of vocal functi- ssue basophils). Degranulation was also
on of larynx. What nerve was constricted? revealed in myocardium and lungs. What
type of hypersensitivity reaction is it?
A. Recurrent laryngeal
B. Diaphragmatic A. Anaphylactic
C. Superior laryngeal B. Delayed-type hypersensitivity
D. Mandibular C. Complement-mediated cytotoxic
E. Sublingual D. Immunocomplex-mediated
E. -
182. A 25 year old man has spent a long
time in the sun under high air humidity. 186. One of sections of central nervous
As a result of it his body temperature rose system has layerwise arrangement of
up to 39oC. What pathological process is neurocytes. Among them there are cells
it? of the following forms: stellate, fusiform,
horizontal, pyramidal. What section of
A. Hyperthermia central nervous system is this structure
B. Infectious fever typical for?
C. Hypothermia
D. Noninfectious fever A. Cortex of cerebrum
E. Burn disease B. Spinal cord
C. Cerebellum
183. A 23 year old man has perforation of D. Medulla oblongata
hard palate. In the area of this perforati- E. Hypothalamus
on there was a compact well-defined
formation. Microscopic examination of 187. Study of fingerprints (dactylography)
the resected formation revealed a large is used by criminalists for personal identi-
focus of caseous necrosis surrounded fication as well as for diagnostics of
by granulation tissue with endovasculi- genetic abnormalities, particularly Dawn’s
 Krok 1 Medicine 2010
disease. What layer of skin determines
individuality of fingerprints?
A. Dermopapillary
B. Horny
C. Reticular
D. Clear (stratum lucidum epidermidis)
E. Basal
188. A patient has herpetic rash. What
medication should be administered?
A. Acyclovir
B. Gentamycin
C. Clotrimazole
D. Benzylpenicillin sodium salt
E. Biseptol
189. Cytogenetic examination of a patient
with reproductive dysfunction revealed
normal karyotype 46 ХY in some cells, but
most cells have karyotype of Klinefelter’s
syndrome - 47 ХХY. Such cell heterogeni-
ty is called:
A. Mosaicism
B. Inversion
C. Transposition
D. Duplication
E. Monomorphism
190. An isolated muscle fiber is under
examination. It was established that the
threshold of stimulation force became si-
gnificantly lower. What is the cause of this
phenomenon?
A. Activation of sodium channels of
membrane
B. Activation of potassium channels of
membrane
C. Inactivation of sodium channels of
membrane
D. Inactivation of potassium channels of
membrane
E. Block of energy production in the cell
191. During examination of a pati-
ent a dentist revealed a lot of "white
spots zones of enamel demineralization.
What microorganisms take part in the
development of this process?
A. Streptococcus mutans
B. Streptococcus salivarius
C. Streptococcus pyogenes
D. Veilonella parvula
E. Staphylococcus epidermidis
192. Surgical approach to the thyroid
gland from the transverse (collar)
approach involves opening of interaponeurotic airless yellowish foci of irregular form,
suprasternal space. What anatomic
21
structure localized in this space is
dangerous to be damaged?
A. Jugular venous arch
B. External jugular vein
C. Subclavicular vein
D. Inferior thyroid arthery
E. Superior thyroid arthery
193. A doctor revealed tissues injury on
patient’s scalp with localized suppurati-
ons and diagnosed his disease as myiasis.
This infestation is caused by larvae of the
following insect:
A. Wohlfahrt fly
B. Kissing bug
C. Stable fly (Stomoxys calcitrans)
D. Malarial mosquito
E. Mosquito
194. A patient with hip fracture was
prescribed a narcotic analgetic. Its
anesthetic action is determined by
interaction with the following receptors:
A. Opiate receptors
B. Adrenoreceptors
C. Cholinoreceptors
D. Benzodiazepine receptors
E. GABA-ergic receptors
195. A patient consumed a lot of reach in
proteins food that caused increase of rate
of proteolytic enzymes of pancreatic juice.
It is also accompanied by increase of rate
of the following enzyme:
A. Tripsin
B. Pepsin
C. Enterokinase
D. Gastricsin
E. Renin
196. In course of an experiment
thalamocortical tracts of an animal were
cut. What type of sensory perception
remained intact?
A. Olfactory
B. Auditory
C. Exteroreceptive
D. Visual
E. Nociceptive
197. A 2 year old child had acute
respiratory viral infection and died
from cardiopulmonary decompensati-
on. Autopsy revealed that his right lung
was hyperemic; in the 2nd, 6th and 10th
segments and on the incision there were
from several mm up to 1 cm large. Mi-
 Krok 1 Medicine 2010 22

croscopical examination revealed exudate 199. An infectious disease caused

consisting mainly of neutrophils in the contractive activity of muscles that
given areas of pulmonary tissue in the contract and dilate eye pupil (paralytic
alveoles, bronchioles and bronchial tubes. state). What functional eye system was
What is the most probable diagnosis? damaged?
A. Focal pneumonia A. Accomodative
B. Interstitial pneumonia B. Dioptric
C. Croupous pneumonia C. Ancillary
D. Acute bronchitis D. Photosensory
E. Pulmonary abscess E. Lacrimal apparatus
198. A 25 year old patient was examined 200. Brain tomography revealed a tumour
by a medical board. Examination revealed in the region of red nucleus. What part of
pathology of chest. Transverse dimensi- brain isdamaged?
ons were to small and the sternum was
strongly protruding. What chest type is it? A. Midbrain
B. Medulla oblongata
A. Keeled chest C. Cerebellum
B. Funnel chest D. Interbrain
C. Flat chest E. Pons cerebelli
D. Cylindrical chest
E. Barrel chest
 Krok 1 Medicine 2011
1. A 30-year-old patient complains
about having abdominal pain and di-
arrhea for five days; body temperature
rise up to 37, 5o C along with chills. The
day before a patient had been in a
forest and drunk from an open water
reservoir. Laboratory analyses enabled
to make the following diagnosis: amebic
dysentery. What is the drug of choice for
its treatment?
A. Metronidazole
B. Furazolidonum
C. Levomycetin
D. Phthalazol
E. Emetine hydrochloride
2. Quite often the cause of secondary
immunodeficiency is an infection
involvement, when the causative agents
propagate directly in the cells of immune
system and destroy it. The following di-
seases are characterized by:
A. Infectious mononucleosis, AIDS
B. Tuberculosis, mycobacteriosis
C. Poliomyelitis, type A hepatitis
D. Dysentery, cholera
E. Q-febris, epidemic typhus
3. Heart rate of a 30-year-old man under
emotional stress reached 112 bpm. The
reason for the heart rate increase is
the altered condition of the following
conducting system of heart:
A. Sinoatrial node
B. Purkinje’s fibers
C. His’ bundle branches
D. Atrioventricular node
E. His’ bundle
4. Sanitary bacteriological research on
water by the membrane filter method
revealed two red colonies on a membrane
filter (Endo agar) through which 500 ml
of analyzed water were passed. Calculate
the coli index and coli titer of the analyzed
water:
A. 4 and 250
B. 2 and 500
C. 250 and 4
D. 500 and 2
E. 250 and 2
5. A 46-year-old female patient has
a continuous history of progressive
muscular (Duchenne’s) dystrophy. Whi-
ch blood enzyme changes will be of di-
agnostic value in this case?
1
A. Creatine phosphokinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate cyclase
6. Extensive thromboembolic infarcti-
on of the left cerebral hemispheres,
large septic spleen, immunocomplex
glomerulonephritis, ulcers on the edges of
the aortic valves, covered with polypous
thrombus with colonies of staphylococcus
were revealed on autopsy of the young
man who died in coma. What disease
caused cerebral thromboemboly?
A. Septic bacterial endocarditis
B. Septicemia
C. Acute rheumatic valvulitis
D. Septicopyemia
E. Rheumatic thromboendocarditis
7. A 10-year-old girl has a history of
repeated acute respiratory viral infection.
After recovering she presents with multi-
ple petechial hemorrhages on the sites of
friction from clothing rubbing the skin.
What kind of hypovitaminosis has this gi-
rl?
A. C
B. B6
C. B1
D. A
E. B2
8. Autopsy of a patient who suffered
from croupous pneumonia and died from
pneumococcal sepsis revealed 900 ml of
turbid greenish-yellow liquid in the ri-
ght pleural cavity. Pleural leaves are dull,
plephoric. Name the clinicopathological
form of inflammation in the pleural cavity:
A. Empyema
B. Fibrinous inflammation
C. Phlegmon
D. Chronic abscess
E. Acute abscess
9. Researchers isolated 5 isoenzymic
forms of lactate dehydrogenase from the
human blood serum and studied their
properties. What property indicates that
the isoenzymic forms were isolated from
the same enzyme?
A. Catalyzation of the same reaction
B. The same molecular weight
C. The same physicochemical properties
D. Tissue localization
E. The same electrophoretic mobility
 Krok 1 Medicine 2011
10. A patient suffering from stomach ulcer
has been treated with an antacid drug
almagel. For acute bronchitis treatment he
was prescribed the antibiotic methacycli-
ne. However within next 5 days the
fever didn’t fall, cough and sputum
nature remained unchanged. A physici-
an came to the conclusion that the drugs
were incompatible. What type of drug
incompatibility is the case?
A. Pharmacokinetic, absorption stage
B. Pharmacokinetic, biotransformation
stage
C. Pharmaceutic
D. Pharmacodynamic
E. Direct antagonism
11. ECG of a 44-year-old patient shows
signs of hypertrophy of both ventricles
and the right atrium. The patient was di-
agnosed with the tricuspid valve insuffici-
ency. What pathogenetic variant of cardiac
dysfunction is usually observed in case of
such insufficiency?
A. Heart overload by volume
B. Heart overload by resistance
C. Primary myocardial insufficiency
D. Coronary insufficiency
E. Cardiac tamponade
12. Proserin increases skeletal muscle tone
when given systematically. Halothane
induces relaxation of skeletal muscles
and reduces proserin effects. What is
the nature of proserin and halothane
interaction?
A. Indirect functional antagonism
B. Direct functional antagonism
C. Competitive antagonism
D. Independent antagonism
E. Noncompetitive antagonism
13. The minute blood volume in a patient
with transplanted heart has increased as a
result of physical activity. What regulati-
ve mechanism is responsible for these
changes?
A. Catecholamines
B. Sympathetic unconditioned reflexes
C. Parasympathetic unconditioned reflexes
D. Sympathetic conditioned reflexes
E. Parasympathetic conditioned reflexes
14. An aged man had raise of arterial
pressure under a stress. It was caused by
activation of:
2
A. Sympathoadrenal system
B. Parasympathetic nucleus of vagus
C. Functions of thyroid gland
D. Functions of adrenal cortex
E. Hypophysis function
15. Autopsy of a man who died from
chronic cardiovascular collapse revealed
"tiger heart". Sidewards of endocardium
a yellowish-white banding can be seen;
myocardium is dull, dark-yellow. What
process caused this pathology?
A. Fatty parenchymatous degeneration
B. Carbohydrate degeneration
C. Hyaline degeneration
D. Fatty vascular-stromal degeneration
E. Amyloidosis
16. A 55-year-old male patient was hospi-
talised to a surgical clinic for suspected
septicemia. What material should be
taken for analysis?
A. Blood, sugar broth
B. Liquor, serum agar
C. Urine, beef-extract broth
D. Pus, yolk saline agar
E. Lymph node punctate, cysteine agar
17. A patient has pellagra. Interrogation
revealed that he had lived mostly on mai-
ze for a long time and eaten little meat.
This disease had been caused by the defi-
cit of the following substance in the maize:
A. Tryptophan
B. Tyrosine
C. Proline
D. Alanine
E. Histidine
18. During examination of a 6-year-
old child a doctor revealed greyi-
sh films on the pharyngeal tonsi-
ls. Their removal provoked moderate
haemorrhage. Bacterioscopy revealed
gram-positive clublike bacteria. What
symptoms will develop in this child within
the next few days if no specific treatment
is provided?
A. Toxic lesions of myocard, liver and
kidney
B. Pulmonary edema
C. Strong paroxysmal cough
D. Papulous skinrash
E. Intermittent fever
19. A 46-year-old patient consulted a
doctor complaining about joint pain that
becomes stronger the day before the
weather changes. Blood examination
 Krok 1 Medicine 2011
revealed an increased concentration of
uric acid. The most probable cause of the
disease is the intensified disintegration of
the following substance:
A. Adenosine monophosphate
B. Cytidine monophosphate
C. Uridine triphosphate
D. Uridine monophosphate
E. Thymidine monophosphate
20. 12 hours after an accute attack of
retrosternal pain a patient presented a
jump of aspartate aminotransferase activi-
ty in blood serum. What pathology is this
deviation typical for?
A. Myocardium infarction
B. Viral hepatitis
C. Collagenosis
D. Diabetes mellitus
E. Diabetes insipidus
21. After a trauma of the upper third
of the anterior forearm surface a patient
presents with difficult pronation, weakeni-
ng of palmar flexor muscles and altered
skin sensitivity of 1-3 fingers. Which nerve
is damaged?
A. n. medianus
B. n. musculocutaneus
C. n. ulnaris
D. n. cutaneus antebrachii medialis
E. n. radialis
22. A 2-year-old child with mental and
physical retardation has been delivered
to a hospital. He presents with frequent
vomiting after having meals. There is
phenylpyruvic acid in urine. Which
metabolism abnormality is the reason for
this pathology?
A. Amino-acid metabolism
B. Lipidic metabolism
C. Carbohydrate metabolism
D. Water-salt metabolism
E. Phosphoric calcium metabolism
23. A 38-year-old man died in the attempt
of lifting weight. He had collaptoid state.
Autopsy revealed an extensive aneurism
rupture of thoracic aorta. He suffered
from visceral syphilis during his lifeti-
me. What pathological process caused
weakness of aortic wall, its dilatation and
rupture?
3
A. Vanishing of elastic fibers
B. Vanishing of collagen fibers
C. Muscle layer atrophy
D. Intima changes by shagreen leather
type
E. Vascularization
24. A patient suffering from myasthenia
has been administered proserin. After its
administration the patient has got nausea,
diarrhea, twitch of tongue and skeletal
muscles. What drug would help to elimi-
nate the intoxication?
A. Atropine sulfate
B. Physostigmine
C. Pyridostigmine bromide
D. Isadrine
E. Mesatonum
25. A man died from an acute infecti-
ous disease accompanied by fever, jaundi-
ce, haemorrhagic rash on the skin
and mucous membranes as well as by
acute renal insufficiency. Histological
examination of renal tissue (stained by
Romanovsky-Giemsa method) revealed
some convoluted bacteria looking like
C und S letters. What bacteria were
revealed?
A. Leptospira
B. Treponema
C. Spirilla
D. Borrelia
E. Campilobacteria
26. A 46-year-old patient suffering from
the diffuse toxic goiter underwent resecti-
on 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?
A. Reduced production of parathormone
B. Increased production of thyroxin
C. Increased production of calcitonin
D. Increased production of thyroliberin
E. Reduced production of thyroxin
27. Medical examination at the mili-
tary registration and enlistment office
revealed that a 15-year-old boy was hi-
gh, with eunuchoid body proportions,
gynecomastia, female pattern of pubic
hair distribution. The boy had also fat
deposits on the thighs, no facial hair, hi-
gh voice, subnormal intelligence quotient.
Which karyotype corresponds with this di-
sease?
 Krok 1 Medicine 2011 4

drug for heartburn elimination. After its

A. 47, XXY ingestion the patient feels better but at the
B. 45, XO same time he has a sensation of stomach
C. 46, XX swelling. Which of the following drugs mi-
D. 46, XY ght be the cause of such side effect?
E. 47, XXX
A. Sodium hydrocarbonate
28. A doctor recommends a patient wi- B. Magnesium oxide
th duodenal ulcer to drink cabbage and C. Magnesium trisilicate
potato juice after the therapy course. D. Aluminium hydrooxide
Which substances contained in these E. Pepsin
vegetables help to heal and prevent the
ulcers? 33. A 30-year-old male patient with acute
pancreatitis has been found to have a
A. Vitamin U disorder of cavitary protein digestion.
B. Pantothenic acid The reason for such condition can be the
C. Vitamin C hyposynthesis and hyposecretion of the
D. Vitamin B1 following enzyme:
E. Vitamin K
A. Tripsin
29. Urine analysis of a 12-year-old boy B. Pepsin
reveals high concentration of all aliphatic C. Lipase
amino acids with the highest excretion D. Dipeptidase
of cystine and cysteine. US of kidneys E. Amylase
revealed kidney concrements. What is the
most likely pathology? 34. A patient has been given high doses
of hydrocortisone for a long time. This
A. Cystinuria caused atrophy of one of the adrenal
B. Alkaptonuria cortex zones. Which zone is it?
C. Cystitis
D. Phenylketonuria A. Fascial
E. Hartnup disease B. Glomerular
C. Reticular
30. A 5-year-old child has been diagnosed D. Glomerular and reticular
with acute right distal pneumonia. E. -
Sputum inoculation revealed that the
causative agent is resistant to penicillin, 35. A victim of an accident has bleeding
but it is senstive to macrolides. What drug from the soft tissues anteriad the mandi-
should be prescribed? bular angle. Which vessel should be li-
gated for the bleeding arrest?
A. Azithromycin
B. Tetracycline A. A.facialis
C. Gentamycin B. A.carotis interna
D. Streptomycin C. A.temporalis superficialis
E. Ampicillin D. A.alveolaris inferior
E. A.lingvalis
31. Autopsy of a 73-year-old man who had
been suffering from the coronary heart di- 36. Microscopic examination of a gram-
sease along with cardiac insufficiency for stained scrape from a patient’s tongue
a long time revealed: nutmeg liver, brown revealed oval, round, elongated chains of
induration of lungs, cyanotic induration dark-violet gemmating cells. What disease
of kidneys and spleen. What kind of ci- can be caused by this causative agent?
rculation disorder was the cause of such
effects? A. Candidiasis
B. Actinomycosis
A. General chronic venous congestion C. Streptococcic infection
B. Arterial hyperaemia D. Staphylococcic infection
C. General acute venous congestion E. Diphtheria
D. Acute anaemia
E. Chronic anaemia 37. The greater amount of nitrogen is
excreted from the organism in form of
32. A patient suffering from chronic urea. Inhibition of urea synthesis and
hyperacidic gastritis takes an antacid accumulation of ammonia in blood and
 Krok 1 Medicine 2011
tissues are induced by the decreased acti-
vity of the following liver enzyme:
A. Carbamoyl phosphate synthetase
B. Aspartate aminotransferase
C. Urease
D. Amylase
E. Pepsin
38. A 36-year-old female patient has a hi-
story of collagen disease. Urine analysis is
likely to reveal an increased concentrati-
on of the following metabolite:
A. Oxyproline
B. Indican
C. Creatinine
D. Urea
E. Urobilinogen
39. A coprological survey revealed light-
colored feces containing drops of neutral
fat. The most likely reason for this condi-
tion is the disorder of:
A. Bile inflow into the bowel
B. Gastric juice acidity
C. Pancreatic juice secretion
D. Intestinal juice secretion
E. Intestinal absorption
40. The secretion of whixh hypophysi-
al hormones will be inhibited after taki-
ng the oral contraceptives containing sex
hormones?
A. Gonadotropic hormone
B. Vasopressin
C. Thyrotrophic hormone
D. Somatotropic hormone
E. Ocytocin
41. A histological specimen of a kidney
shows a part of the distal tubule going
between the afferent and efferent arteri-
ole. The cells building the tubule wall have
dense nuclei; basal membrane is absent.
Such structural formation is called:
A. Macula densa
B. Juxtaglomerular cells
C. Mesangial cells
D. Juxtavascular cells
E. -
42. During preparation of a patient to a
heart surgery it was necessary to measure
pressure in heart chambers. In one of
them pressure varied from 0 mm Hg up
to 120 mm Hg within one cardiac cycle.
What heart chamber is it?
5
A. Left ventricle
B. Right ventricle
C. Right atrium
D. Left atrium
E. -
43. A patient with essential hypertensi-
on has a high rate of blood renin. Whi-
ch of antihypertensive drugs should be
preferred?
A. Lisinopril
B. Propranolol
C. Prazosinum
D. Nifedipine
E. Dichlothiazide
44. In order to determine toxigenicity of
diphtheria bacilli a strip of filter paper
impregnated with antitoxic diphtherial
serum was put on the dense nutrient medi-
um. There were also inoculated a mi-
crobal culture under examination and a
strain that is known to be toxigenic. If
the microbal culture under examinati-
on produces exotoxin, this wil result in
formation of:
A. Precipitin lines
B. Haemolysis zones
C. Zones of diffuse opacification
D. Zones of lecithovitellinous activity
E. Precipitin ring
45. It was revealed that T-lymphocytes
were affected by HIV. Virus enzyme -
reverse transcriptase (RNA-dependent
DNA-polymerase) - catalyzes the
synthesis of:
A. DNA on the matrix of virus mRNA
B. Virus informational RNA on the matrix
of DNA
C. DNA on virus ribosomal RNA
D. Viral DNA on DNA matrix
E. mRNA on the matrix of virus protein
46. Microscopical examination of an
enlarged cervical lymph node revealed
blurring of its structure, absence of
lymphoid follicles; all the microscopic fi-
elds showed cells with roundish nuclei and
thin limbus of basophil cytoplasm. It is
known from the clinical data that other
groups of lymph nodes are also enlarged
as well as spleen and liver. What disease
might be suspected?
 Krok 1 Medicine 2011 6

A. Lymphoid leukosis A. Dobutamine

B. Lymphogranulomatosis
C. Lymphosarcoma
D. Myeloid leukosis
E. Multiple myeloma
47. A 38-year-old patient came to a
traumatology centre and complained
about an injury of his right hand. Objecti-
vely: the patient has a cut wound in the
region of the thenar eminence on the right
hand; distal phalanx of the I finger cannot
be flexed. What muscle was injured?
A. Long flexor muscle of thumb
B. Short flexor muscle of thumb
C. Short abductor muscle of thumb
D. Opposer muscle of thumb
E. Abductor muscle of thumb
48. Lung ventilation in a person is
increased as a result of physical activi-
ty. Which of the following indices of the
external respiration is much higher than
in a state of rest?
A. Respiratory volume
B. Vital capacity of lungs
C. Inspiratory reserve volume
D. Expiratory reserve volume
E. Total lung capacity
49. As a result of activation of the ion
channels of the external membrane the
rest potential of an excitable cell has
greatly increased. What channels were
activated?
A. Potassium channels
B. Sodium channels
C. Fast calcium channels
D. Slow calcium channels
E. Sodium and calcium channels
50. As a result of continuous starvati-
on the glomerular filtration rate has
increased by 20%. The most probable
cause of the glomerular filtration alterati-
on under the mentioned conditions is:
A. Decrease in the oncotic pressure of
blood plasma
B. Increase in the systemic arterial pressure
C. Increase in the permeability of the renal
filter
D. Increase of the filtartion quotient
E. Increase of the renal blood flow
51. A patient with cardiogenic shock,
hypotension, asphyxia and edemata was
given an injection of non-glycosidic cardi-
otonic. What drug was injected?
B. Caffeine sodium benzoate
C. Cordiamin
D. Aethimizolum
E. Bemegride
52. After transfusion of 200 ml of blood a
patient presented with body temperature
rise up to 37, 9oC. Which of the followi-
ng substances is the most likely cause of
temperature rise?
A. Interleukin-1
B. Interleukin-2
C. Tumour necrosis factor
D. Interleukin-3
E. Interleukin-4
53. A man who is riding the carousel
presents with increased heart rate, sweati-
ng, nausea. This condition is caused pri-
marily by the stimulation of the following
receptors:
A. Vestibular ampullar
B. Proprioceptors
C. Vestibular otolithic
D. Auditory
E. Visual
54. A worker of a cattle farm fell acutely
ill and then died from the progressing
intoxication. Autopsy revealed enlarged,
hyposthenic spleen of dark-cherry colour
when dissected; excessive pulp scraping.
At the base and fornix of brain pia maters
are edematous, soaked with blood, dark-
red ("scarlet hat"). Microscopic exami-
nation revealed serous haemorrhagic
inflammation of brain tissues and tuni-
cs along with destruction of small vessel
walls. What is the most likely diagnosis?
A. Anthrax
B. Tularemia
C. Brucellosis
D. Plaque
E. Cholera
55. Which of the listed diuretic agents WI-
LL NOT have diuretic effect on a patient
with Addison’s disease?
A. Spironolactone
B. Furosemide
C. Hydrochlorothiazide
D. Triamterene
E. Ethacrynic acid
56. A man with a wound of his limb that
had been suppurating for a long time di-
ed from intoxication. Autopsy revealed
extreme emaciation, dehydration, brown
 Krok 1 Medicine 2011
atrophy of liver, myocardium, spleen and
cross-striated muscles as well as renal
amyloidosis. What diagnosis corresponds
with the described presentations?
A. Chroniosepsis
B. Septicopyemia
C. Septicemia
D. Chernogubov’s syndrome
E. Brucellosis
57. This drug has a destructive effect on
erythrocytic forms of malarial plasmodia
and dysenteric amoebae. It is used for
treatment and prevention of such diseases
as malaria, amebiasis and interstitial di-
sease. What drug is it?
A. Chingamin
B. Emetine hydrochloride
C. Tetracycline
D. Erythromycin
E. Quinine
58. A patient has an increased pyruvate
concentration in blood, most of it is
excreted with the urine. What kind of avi-
taminosis has this patient?
A. B1
B. E
C. B3
D. B6
E. B2
59. A child suffers from drug idiosyncrasy.
What is the cause of such reaction?
A. Hereditary enzymopathy
B. Exhaustion of substrate interacting with
pharmaceutical substance
C. Accumulation of pharmaceutical
substance
D. Inhibition of microsomal liver enzymes
E. Associated disease of target organ
60. One of the parents is suspected of
having phenylketonuria recessive gene.
What is the risk of giving birth to a chi-
ld with inborn phenylketonuria?
A. 0%
B. 25%
C. 50%
D. 75%
E. 100%
61. Pulmonary examination of a pati-
ent who has worked as a stone grinder
for 9 years revealed small dense roundi-
sh nodules consisting of connective ti-
ssue. The nodules were found to have
peripheral macrophages. Such pulmonary
7
alterations are indicative of the following
disease:
A. Silicosis
B. Acute pneumonia
C. Multiple bronchiectasis
D. Chronic bronchitis
E. Bronchial asthma
62. A 12-year-old teenager has signifi-
cantly put off weight within 3 months;
glucose concentration rose up to 50 mi-
llimole/l. He fell into a coma. What is the
main mechanism of its development?
A. Hyperosmolar
B. Hypoglycemic
C. Ketonemic
D. Lactacidemic
E. Hypoxic
63. Which way of heat emission by the
bodies of greenhouse workers is the most
effective at the temperature of 36o C
degrees and relative humidity of 70%?
A. Liquid evaporation
B. Thermal conduction
C. Heat radiation
D. Convection
E. -
64. Examination of a 70-year-old pati-
ent revealed insulin-dependent diabetes.
What drug should be administered?
A. Glibenclamid
B. Insulin
C. Mercazolilum
D. Parathyroidin
E. Cortisone
65. A disaster fighter at a nuclear power
plant developed hemorrhagic syndrome
on the background of acute radiation di-
sease. What is the most important factor
of syndrome pathogenesis?
A. Thrombocytopenia
B. Vascular wall damage
C. Increased activity of fibrinolysis factors
D. Increased activity of anticoagulative
system factors
E. Decreased activity of coagulative factors
66. Jaundice treatment involves admi-
nistration of barbiturates inducing the
synthesis of UDP-glucuronyl transferase.
A medicinal effect is caused by the
production of:
 Krok 1 Medicine 2011
A. Direct reacting (conjugated) bilirubin
B. Indirect reacting (unconjugated) bili-
rubin
C. Biliverdin
D. Protoporphyrin
E. Heme
67. A histological specimen shows a
blood vessel. Its inner coat is composed
by endothelium, subendothelium and
internal elastic membrane. The middle
coat is enriched with smooth myocytes.
Such morphological characteristics are
typical for the following vessel:
A. Muscular-type artery
B. Elastic-type artery
C. Capillary
D. Non-muscular vein
E. Muscular-type vein
68. An 18-year-old man was delivered to
the hospital after a road accident. Exami-
nation at the traumatological department
revealed multiple injuries of soft tissues of
face in the region of the medial eye angle.
The injuries caused massive haemorrhage.
What arterial anastomosis might have
been damaged in this region?
A. a. carotis externa et a. carotis interna
B. a. carotis externa et a. subclavia
C. a. carotis interna et a. subclavia
D. a. subclavia et a. ophthalmica
E. a. carotis interna et a. ophthalmica
69. Autopsy of a 75-year-old man with a
long history of atherosclerosis revealed a
grey irregular-shaped focus of loose consi-
stency in the right parietotemporal region
of brain. What is the most likely cause of
this process?
A. Thrombosis of the right medial cerebral
artery
B. Thrombosis of the right anterior
cerebral artery
C. Thrombosis of the right posterior
cerebral artery
D. Thrombosis of basilar artery
E. Thrombosis of tomentum cerebri
70. Autopsy of a man with a mali-
gnant stomach tumour who had di-
ed from cancer intoxication revealed
in the posteroinferior lung fields some
dense, grayish-red irregular foci protrudi-
ng above the section surface. Microscopic
examination revealed exudate containi-
ng a large amount of neutrophils in the
lumen and walls of small bronchi and
alveoles. Such pulmonary alterations indi-
cate the following disease:
8
A. Acute purulent bronchopneumonia
B. Acute bronchitis
C. Croupous pneumonia
D. Intermittent pneumonia
E. Acute serous bronchopneumonia
71. A surgeon has to find the common
hepatic duct during the operative
intervention on account of concrements in
the gall ducts. The common hepatic duct
is located between the leaves of:
A. Hepatoduodenal ligament
B. Hepatogastric ligament
C. Hepatorenal ligament
D. Round ligament of liver
E. Venous ligament
72. Autopsy of a 1,5-year-old chi-
ld revealed haemorrhagic skin rash,
moderate hyperaemia and edema of
nasopharyngeal mucous membrane, small
haemorrhages in the mucous membranes
and internal organs; dramatic dystrophic
alterations in liver and myocardium; acute
necrotic nephrosis; massive haemorrhages
in the adrenal glands. What disease are
these alterations the most typical for?
A. Meningococcal infection
B. Scarlet fever
C. Diphtheria
D. Measles
E. Epidemic typhus
73. A 75-year-old-female patient wi-
th complaints of visual impairment has
been delivered to the ophthalmologic
department. Objective examination
revealed a brain tumor in area of the left
optic tract. The patient has a visual field
defect in the following area:
A. Left half of both eyes retina
B. Right half of both eyes retina
C. Left and right halves of the left eye
retina
D. Left and right halves of the right eye
retina
E. Left and right halves of both eyes retina
74. A patient with coronary disease
has been diagnosed with myocardial
hypertrophy, tachycardia and a decrease
in minute blood volume. What is the
leading mechanism of cardiac hystiocyte
damage in this case?
 Krok 1 Medicine 2011
A. Damage of specific membrane pumps
B. Increase in α and β adrenoreceptors
quantity
C. Mg 2+ loss by cardiac hystiocytes
D. Ca2+ loss by cardiac hystiocytes
E. Cardiac hystiocyte dehydration
75. Blood analysis of a patient wi-
th jaundice reveals conjugated bilirubi-
nemia, increased concentration of bile aci-
ds. There is no stercobilinogen in urine.
What type of jaundice is it?
A. Obstructive jaundice
B. Hepatocellular jaundice
C. Parenchymatous jaundice
D. Hemolytic jaundice
E. Cythemolytic jaundice
76. While studying maximally spiralized
chromosomes of human karyotype the
process of cell division was stopped in the
following phase:
A. Metaphase
B. Prophase
C. Interphase
D. Anaphase
E. Telophase
77. A man is being measured power inputs
on an empty stomach, in the lying posi-
tion, under conditions of physical and
psychic rest at a comfortable temperature.
Power inputs will reach the maximum at:
A. 5-6 p.m.
B. 7-8 a.m.
C. 10-12 a.m.
D. 2-3 p.m.
E. 3-4 a.m.
78. When measuring power inputs of a
man by the method of indirect calori-
metry the following results were obtained:
1000 ml oxygen consumption and 800 ml
carbon dioxide liberation per minute. The
man under examination has the following
respiratory coefficient:
A. 0,8
B. 1,25
C. 0,9
D. 0,84
E. 1,0
79. A newborn child with pylorostenosis
has often repeating vomiting accompani-
ed by apathy, weakness, hypertonicity,
sometimes convulsions. What disorder
form of acid-base balance is it?
9
A. Nongaseous alkalosis
B. Gaseous alkalosis
C. Gaseous acidosis
D. Metabolic acidosis
E. Excretory acidosis
80. A concentrated solution of sodium
chloride was intravenously injected to an
animal. This caused decreased reabsorpti-
on of sodium ions in the renal tubules. It
is the result of the following changes of
hormonal secretion:
A. Aldosterone reduction
B. Aldosterone increase
C. Vasopressin reduction
D. Vasopressin increase
E. Reduction of atrial natriuretic factor
81. A patient has been diagnosed with
alkaptonuria. Choose an enzyme whose
deficiency can be the reason for this
pathology:
A. Homogentisic acid oxidase
B. Phenylalanine hydroxylase
C. Glutamate dehydrogenase
D. Pyruvate dehydrogenase
E. Dioxyphenylalanine decarboxylase
82. A patient consulted an urologist about
pain during urination. Analysis of his uri-
ne taken in the daytime revealed eggs wi-
th a characteristic sharp point. It is known
from the anamnesis that the patient has
recently returned from Australia. What is
the most likely diagnosis?
A. Urogenital schistosomiasis
B. Intestinal schistosomiasis
C. Japanese schistosomiasis
D. Opisthorchiasis
E. Dicroceliasis
83. A 49-year old female patient has limi-
tation of left limbs arbitrary movements.
Muscular tonus of left hand and leg is
overstrained and spasmodic, local tendon
reflexes are strong, pathological reflexes
are presented. What is the most likely
development mechanism of hypertensi-
on and hyperreflexia?
A. Reduction of descending inhibitory
influence
B. Motoneuron activation induced by
stroke
C. Activation of excitatory influence from
the focus of stroke
D. Activation of synaptic transmission
E. Ihibition of cerebral cortex
motoneurons
 Krok 1 Medicine 2011
84. A 35-year-old patient complains about
having severe rhinitis and loss of sense
of smell for a week. Objectively: the nasal
cavity contains a lot of mucus covering the
mucous membrane and blocking olfactory
receptors. In what region of the nasal cavi-
ty are these receptors located?
A. Superior nasal concha
B. Median nasal concha
C. Inferior nasal concha
D. Common nasal meatus
E. Vestibule of nose
85. A 10-year-old child had the mantoux
tuberculin test administered. 48 hours
later a papule up to 8 mm in diameter
appeared on the site of the injection.
What type of hypersensitivity reaction
developed after the tuberculin injection?
A. Type IV hypersensitivity reaction
B. Arthus phenomenon
C. Seroreaction
D. Atopic reaction
E. Type II hypersensitivity reaction
86. Vitamin B1 deficiency causes di-
sturbance of oxidative decarboxylati-
on of α-ketoglutaric acid. This leads to
the impaired synthesis of the following
coenzyme:
A. Thiamine pyrophosphate
B. Nicotinamide adenine dinucleotide
C. Flavine adenine dinucleotide
D. Lipoic acid
E. Coenzyme A
87. Examination of a pregnant woman
having Rh-negative blood revealed hi-
gh level of antierythrocytic antibodies.
For its reduction she was implanted wi-
th her husband’s Rh-positive skin graft.
The graft was rejected in two weeks.
Its microscopic examination revealed ci-
rculatory disturbance, edema and cellular
infiltration with lymphocytes, neutrophils
and macrophages predominance. What is
the most likely pathology?
A. Graft immunity
B. Immediate hypersensitivity
C. Delayed-type hypersensitivity
D. Granulomatous inflammation
E. Interstitial inflammation
88. A 17-year-old girl took a high dose
of phenobarbital to commit a suici-
de. An ambulance doctor cleansed her
stomach and gave her an intravenous
injection of bemegride and sodium
hydrocarbonate solution. What was sodi-
10
um hydrocarbonate injected for?
A. For increasing renal excretion of
phenobarbital
B. For breathing stimulation
C. For arterial pressure normalization
D. For phenobarbital inactivation
E. For bringing the patient to consci-
ousness
89. While examining the oral cavity a
stomatologist revealed inflammation of
papillae on the border of the median
and posterior third of the back of tongue.
What papillae are inflamed?
A. Papillae vallatae
B. Papillae fungiformes
C. Papillae foliatae
D. Papillae filiformes
E. Papillae conicae
90. A patient is 44 years old. Laboratory
examination of his blood revealed that
content of proteins in plasma was 40 g/l.
What influence will be exerted on the
transcapillary water metabolism?
A. Filtration will be increased, reabsorpti-
on - decreased
B. Both filtration and reabsorption will be
increased
C. Both filtration and reabsorption will be
decreased
D. Filtration will be decreased, reabsorpti-
on - increased
E. Metabolism will stay unchanged
91. A patient has corestenoma. What is
the reason of such condition?
A. Increased tonus of parasympathetic
centres
B. Increased tonus of sympathetic centres
C. Increased activity of sympathoadrenal
system
D. Adrenaline action
E. Noradrenaline action
92. A 46-year-old man had a bulging
dark macula on skin that caused no di-
scomfort. With time it began to increase
in size and became painful. It turned dark
brown and there was a nodule on palpati-
on. Histological examination of tissues
revealed spindle and polymorphous cells
with multiple mitoses. Their cytoplasm
contained brown pigment. What tumour
is it?
 Krok 1 Medicine 2011 11

A. Melanoma A. Axillary nerve

B. Basalioma
C. Hemangioma
D. Nevus
E. -
93. The patient with complaints of
permanent thirst applied to the doctor.
Hyperglycemia, polyuria and increased
concentration of 17-ketosteroids in the
urine were revealed. What disease is the
most likely?
A. Steroid diabetes
B. Insulin-dependent diabetes mellitus
C. Myxoedema
D. Type I glycogenosis
E. Addison’s disease
94. A 32-year-old patient consulted a
doctor about the absence of lactation
after parturition. Such disorder might be
explained by the deficit of the following
hormone:
A. Prolactin
B. Somatotropin
C. Vasopressin
D. Thyrocalcitonin
E. Glucagon
95. An infant has pylorospasm, weakness,
hypodynamia, convulsions as a result of
frequent vomiting. What kind of acid-base
disbalance is it?
A. Excretory alkalosis
B. Excretory acidosis
C. Metabolic acidosis
D. Exogenous nongaseous acidosis
E. Gaseous alkalosis
96. A weightlifter has a disruption of
thoracic lymphatic duct as a result of li-
fting a weight. Choose the most likely site
of injury:
A. In the region of aortic hiatus
B. In the region of lumbosacral plexus
C. In the posterior mediastinum
D. In the region of venous angle
E. In the region of neck
97. A woman suffering from osteochondrosis
has acute pain in her humeral articulation
that gets worse when she tries to abduct
her shoulder. These symptoms might be
caused by damage of the following nerve:
B. Subscapular nerve
C. Dorsal scapular nerve
D. Subclavicular nerve
E. Thoracodorsal nerve
98. Pyeloureterography X-ray photo
showed a renal pelvis with minor calyces
only (major calyces were absent). What
form of urinary tracts of a kidney was
revealed?
A. Embryonal
B. Fetal
C. Mature
D. Ampullar
E. -
99. A female patient presents with
endocrine dysfunction of follicular cells
of the ovarian follicles resulting from
an inflammation. The synthesis of the
following hormone will be inhibited:
A. Estrogen
B. Progesterone
C. Lutropin
D. Follicle stimulating hormone
E. Follistatine
100. A 19-year-old female patient has
had low haemoglobin rate of 90-95 g/l si-
nce childhood. Blood count results obtai-
ned after hospitalisation are as follows:
erythrocytes - 3, 2 · 1012 /l, Hb- 85 g/l,
colour index - 0,78; leukocytes - 5, 6 · 109 /l,
platelets - 210 · 109 /l. Smear examinati-
on revealed anisocytosis, poikilocytosis
and target cells. Reticulocyte rate is 6%.
Iron therapy was ineffective. What blood
pathology corresponds with the described
clinical presentations?
A. Thalassemia
B. Enzymopathy
C. Membranopathy
D. Sickle-cell anemia
E. Favism
101. A liquidator of a breakdown at a
nuclear power plant who was irradiated
complained about vomiting that occurs all
of a sudden. What medication should be
prescribed?
A. Metoclopramide
B. Reserpine
C. Atropine
D. Aeron
E. De-Nol
102. A patient with acute myocardial
infarction has been administered heparin
 Krok 1 Medicine 2011
as a part of complex therapy. Some
time after heparin injection the pati-
ent developed hematuria. What heparin
antagonist should be injected in order to
manage the complication?
A. Protamine sulfate
B. Vicasol
C. Aminocaproic acid
D. Neodicumarin
E. Fibrinogen
103. 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?
A. Atrioventricular
B. Sinus
C. Atrial
D. Ventricular
E. Bundle-branch
104. A patient complains of hydruria (7
liters per day) and polydipsia. Examinati-
on reveals no disorders of carbohydrate
metabolism. These abnormalities might
be caused by the dysfunction of the
following endocrine gland:
A. Neurohypophysis
B. Adenohypophysis
C. Islets of Langerhans (pancreatic islets)
D. Adrenal cortex
E. Adrenal medulla
105. Before a surgery a blood sample of a
30-year-old man has been typed. Blood
is Rh-positive. Standard serums of such
groups as 0 αβ (I), Аβ (II), Вα (III) didn’t
activate erythrocyte agglutination reacti-
on. The group of the analyzed blood is:
A. 0 αβ (I)
B. Аβ (II)
C. Вα (III)
D. АВ (IV)
E. -
106. Medical examination of a 20-year-
old woman revealed a dense incapsulated
node 1 cm in diameter that was palpated
in the mammary gland. The postoperati-
ve biopsy revealed connective tissue
overgrowth around the mammary ducts
and glandular components of different di-
ameter that didn’t make lobules and bore
no signs of cellular abnormality. What di-
agnosis will be made?
12
A. Fibroadenoma
B. Fibroma
C. Metastatic cancer
D. Adenoma
E. Fibrocarcinoma
107. A 38-year-old male patient has been
ill with systemic lupus erythematosus for
three years. He was diagnosed with diffuse
renal affection accompanied by massi-
ve edemata and expressive proteinuria.
What is the most likely cause of protei-
nuria development?
A. Autoimmune renal affection
B. Aseptic renal affection
C. Ischemic renal affection
D. Urinary bladder inflammation
E. Urinary tracts inflammation
108. A student failed to answer all the
questions of examination paper correctly.
As a result he blushed, felt hot and
lost confidence. What type of arterial
hyperemia has developed in this case?
A. Neurotonic hyperemia
B. Neuroparalytic hyperemia
C. Metabolic hyperemia
D. Pathologic hyperemia
E. Postishemic hyperemia
109. Acute renal impairment caused
death of a bleeding patient. Autopsy
revealed enlarged kidneys with a broad
pale pink cortical layer expressively
demarcated from dark red renal pyrami-
ds. Macroscopic examination revealed
lack of epithelial nuclei of convoluted
tubules, tubulorrhexis, phlebostasis. The
cell nuclei of choroid glomus and straight
tubules were present. What pathology is
it?
A. Necronephrosis
B. Infarction
C. Glomerulonephritis
D. Pyelonephritis
E. Nephrosis
110. A female patient consulted a doctor
about pain and limited movements in
the knee joints. Which of the followi-
ng nonsteroid anti-inflammatory drugs
should be administered taking into consi-
deration that the patient has a history of
chronic gastroduodenitis?
 Krok 1 Medicine 2011
A. Celecoxib
B. Diclofenac sodium
C. Promedol
D. Acetylsalicilic acid
E. Butadiounum
111. A patient presents with icteriti-
ousness of skin, scleras and mucous
membranes. Blood plasma the total bili-
rubin is increased, stercobilin is increased
in feces, urobilin is increased in urine.
What type of jaundice is it?
A. Haemolytic
B. Gilbert’s disease
C. Parenchymatous
D. Obturational
E. Cholestatic
112. Blood plasma of a healthy man
contains several dozens of proteins. Duri-
ng an illness new proteins can originate,
namely the protein of "acute phase".
Select such protein from the listed below:
A. C-reactive protein
B. Prothrombin
C. Fibrinogen
D. G immunoglobulin
E. A immunoglobulin
113. A patient working at a pig farm
complains about paroxysmal abdomi-
nal pain, liquid feces with admixtures of
mucus and blood, headache, weakness,
fever. Examination of large intestine
revealed ulcers from 1 mm up to several
cm large, feces contained oval unicellular
organisms with cilia. What disease should
be suspected?
A. Balantidiasis
B. Amebiasis
C. Toxoplasmosis
D. Lambliasis
E. Trichomoniasis
114. During hypersensitivity test a patient
got subcutaneous injection of an antigen
which caused reddening 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. Decarboxylation
B. Methylation
C. Phosphorylation
D. Isomerization
E. Deaminization
115. During fighting a man had a cardiac
arrest as a result of a hard blow to the
13
upper region of anterior abdominal wall.
Which of the described mechanisms might
have provoked the cardiac arrest?
A. Parasympathetic unconditioned reflexes
B. Sympathetic unconditioned reflexes
C. Parasympathetic conditioned reflexes
D. Sympathetic conditioned reflexes
E. Peripheric reflexes
116. There is a severe time restriction for
people’s staying at a height of over 800
m above the sea level without oxygen
bombs. What is the life limiting factor in
this case?
A. Partial oxygen pressure
B. Ultraviolet intensity
C. Moisture level
D. Temperature
E. Earth gravity
117. A patient with marked pneumofi-
brosis that developed after infiltrati-
ng pulmonary tuberculosis has been di-
agnosed with respiratory failure. What is
its pathogenetic type?
A. Restrictive
B. Obstructive
C. Dysregulatory
D. Reflex
E. Apneistic
118. During surgical manipulations a pati-
ent has been given novocaine injection for
anesthesia. 10 minutes later the patient
developed paleness, dyspnea, hypotensi-
on. What type of allergic reaction is it?
A. Anaphylactic immune reaction
B. Cellulotoxic immune reaction
C. Aggregate immune reaction
D. Stimulating immune reaction
E. Cell-mediated immune reaction
119. A sensitive neural ganglion consists
of roundish neurocytes with one extensi-
on that divides into axon and dendrite at a
some distance from the perikaryon. What
are these cells called?
A. Pseudounipolar
B. Unipolar
C. Bipolar
D. Multipolar
E. Apolar
120. A patient complained about di-
zziness, memory impairment, periodical
convulsions. It was revealed that these
changes were caused by a product of
decarboxylation of glutamic acid. Name
 Krok 1 Medicine 2011 14

this product: a big irregular round-shaped cell. There

are a lot of intracellular tubules and mi-
A. GABA tochondria in the cytoplasm. Specify this
B. Pyridoxal phosphate cell:
C. TDP
D. ATP A. Parietal cell
E. THFA B. Principal cell
C. Undifferentiated cell
121. It was found out that some D. Mucous cell
compounds, for instance fungi toxins and E. Endocrine cell
some antibiotics can inhibit activity of
RNA-polymerase. What process will be 126. Blood count of an athlete is as
disturbed in a cell in case of inhibition of follows: erythrocytes - 5, 5 · 1012 /l, Hb-
this enzyme? 180 g/l, leukocytes - 7 · 109 /l, neutrophils -
64%, basophils - 0,5%, eosinophils - 0,5%,
A. Transcription monocytes - 8%, lymphocytes - 27%. First
B. Processing of all, such results indicate the stimulation
C. Replication of:
D. Translation
E. Reparation A. Erythropoiesis
B. Leukopoiesis
122. During an experiment the myotatic C. Lymphopoiesis
reflex has been studied in frogs. After D. Granulocytopoiesis
extension in a skeletal muscle its E. Immunogenesis
reflectory contraction was absent. The
reason for it might be a dysfunction of 127. A patient died from cardiopulmonary
the following receptors: decompensation. Histological examinati-
on revealed diffused pulmonary affection
A. Muscle spindles along with interstitial edema, infiltration
B. Nociceptors of tissue by limphocytes, macrophages,
C. Articular plasmocytes; pulmonary fibrosis, panaci-
D. Golgi tendon organs nar emphysema. What is the most likely
E. Tactile diagnosis?
123. An adult man presents with systemic A. Fibrosing alveolitis
arterial pressure drop from 120/70 to B. Chronic bronchitis
90/50 mm Hg. This resulted in reflex C. Bronchopneumonia
vasoconstriction. Vasoconstriction will be D. Pulmonary atelectasis
minimal in the following organ: E. Bronchial asthma
A. Heart 128. If a man has an attack of bronchi-
B. Skin ospasm it is necessary to reduce the effect
C. Bowels of vagus on smooth muscles of bronchi.
D. Skeletal muscles What membrane cytoreceptors should be
E. Liver blocked for this purpose?
124. A culture of monkey cells (Vero) and A. M-cholinoreceptors
a group of mouse sucklings were infected B. N-cholinoreceptors
with an inoculum taken from a child with C. α-adrenoreceptors
provisional diagnosis "enterovirus infecti- D. β-adrenoreceptors
on". There was no cytopathic effect on E. α- and β-adrenoreceptors
the cell culture but mouse sucklings died.
What enteric viruses might have caused 129. A male patient has been di-
disease of this child? agnosed with gastric ulcer. Bacteriologi-
cal examination of biopsy material from
A. Coxsackie A the affected part of stomach revealed
B. Coxsackie B small colonies of gram-negative, oxide
C. ECHO virus reductase-positive flexibacteria that grew
D. Polioviruses on the chocolate agar on the fifth day.
E. Unclassified enteric viruses 68-71 Which of the following microorganisms
is the most likely causative agent?
125. An electron microphotography of a
fragment of proper gastric gland shows
 Krok 1 Medicine 2011
A. Helicobacter pylori
B. Campilobacter jejuni
C. Campilobacter fetus
D. Mycoplasma hominis
E. Chlamydia trachomatis
130. There are several groups of
molecular mechanisms playing important
part in pathogenesis of insult to cells
which contributes to the pathology
development. What processes are sti-
mulated by proteinic damage mechani-
sms?
A. Enzyme inhibition
B. Lipid peroxidation
C. Phospholipase activation
D. Osmotic membrane distension
E. Acidosis
131. A patient has been diagnosed wi-
th a compression fracture of a lumbar
vertebra. As a result he has a consi-
derable increase in curvature of the
lumbar lordosis. Which ligament damage
can induce such changes in the spine
curvature?
A. Anterior longitudinal ligament
B. Posterior longitudinal ligament
C. Yellow ligament
D. Iliolumbar ligament
E. Interspinous ligament
132. A 49-year-old patient with croupous
pneumonia died from pneumococcal
septicemia. Autopsy revealed up to 700
ml of turbid greenish-yellow foul-smelling
liquid in the left pleural cavity. The pleural
leaflets were dull and plethoric. What
form of pleural inflammation is it?
A. Empyema
B. Chronic abscess
C. Acute abscess
D. Phlegmon
E. Fibrinous inflammation
133. A 35-year-old man developed acute
heart failure while running for a long time.
What changes in ionic composition can be
observed in the cardiac muscle?
15
A. Accumulation of Na+ and Ca2+ ions in
the myocardium cells
B. Accumulation of K + and Mg 2+ ions in
the myocardium cells
C. Reduction of Na+ and Ca2+ ions in the
myocardium cells
D. Reduction of K + and Mg 2+ ions in the
extracellular space
E. Reduction of Na+ and Ca2+ ions in the
extracellular space
134. A child with a history of
frequent angine and pharyngitis has
been diagnosed with lymphadenopathy
and splenomegaly. His appearance is
characterised by pastosity and paleness,
muscular tissue is poorly developed.
Lymphocytosis is present. What kind of
diathesis is it?
A. Lymphohypoplastic diathesis
B. Exudative diathesis
C. Gouty diathesis
D. Asthenic diathesis
E. Hemorrhagic diathesis
135. In response to a change in body posi-
tion from horizontal to vertical blood
circulation system develops reflectory
pressor reaction. Which of the following
is its compulsory component?
A. Systemic constriction of the venous
vessels
B. Systemic dilatation of the arterial resi-
stive vessels
C. Decrease in the circulating blood
volume
D. Increase in the heart rate
E. Weakening of the pumbing ability of
heart
136. After an immunoassay a chi-
ld was diagnosed with immunodefici-
ency of humoral immunity. What is the
reason for the primary immunodeficiency
development in the child?
A. Hereditary abnormality of immune
system
B. Embryonal development abnormalities
C. Pathometabolism in mother’s organism
D. Immune responsiveness and resistance
disorders
E. Toxic damage of B-lymphocytes
137. Life cycle of a cell includes the
process of DNA autoreduplication. As a
result of it monochromatid chromosomes
turn into bichromatid ones. What period
of cell cycle does this phenomenon fall
into?
 Krok 1 Medicine 2011
A. S
B. Go
C. G1
D. G2
E. M
138. Examination of a 12-year-old
boy with developmental lag revealed
achondroplasia: disproportional consti-
tution with evident shortening of upper
and lower limbs as a result of growth
disorder of epiphyseal cartilages of long
tubal bones. This disease is:
A. Inherited, dominant
B. Inherited, recessive
C. Inherited, sex-linked
D. Congenital
E. Acquired
139. 2 days after labour a woman
developed shock along with DIC
syndrome that caused her death. Autopsy
revealed purulent endomyometritis, regi-
onal purulent lymphangitis, lymphadeni-
tis and purulent thrombophlebitis. There
were also dystrophic alterations and
interstitial inflammation of parenchymal
organs. What is the most likely diagnosis?
A. Septicemia
B. Syphilis
C. Tuberculosis of genital organs
D. Chorioadenoma destruens
E. Hydatid mole
140. After a craniocerebral trauma a pati-
ent lost the ability to execute learned
purposeful movements (apraxia). The
injury is most likely localized in the
following region of the cerebral cortex:
A. Gyrus supramarginalis
B. Gyrus angularis
C. Gyrus paracentralis
D. Gyrus lingualis
E. Gyrus parahippocampalis
141. Tissue inosytol triphosphates are
generated as a result of the phosphati-
dylinositol diphosphate hydrolysis and
act as secondary agents (mediators) in
the mechanism of hormone action. Their
effect in cells is directed at:
A. Calcium ion liberation from cellular
depot
B. Adenylate cyclase activation
C. Protein kinase A activation
D. Phosphodiesterase inhibition
E. Protein kinase A inhibition
16
142. A patient with coronary disease
and arrhythmia has been administered a
drug that blocks potassium channels and
prolongs the action potential. What drug
is it?
A. Amiodarone
B. Corglyconum
C. Nitroglycerin
D. Dobutamine
E. Lisinopril
143. A patient takes digoxin for cardiac
insufficiency. What diuretic may increase
digoxin toxicity due to the intensified
excretion of K + ions?
A. Hydrochlorothiazide
B. Spironolactone
C. Panangine
D. Siliborum
E. Lisinopril
144. During starvation muscle proteins
break up into free amino acids. These
compounds will be the most probably
involved into the following process:
A. Gluconeogenesis in liver
B. Gluconeogenesis in muscles
C. Synthesis of higher fatty acids
D. Glycogenolysis
E. Decarboxylation
145. A female patient consulted a doctor
about a sense of epigastric discomfort,
nausea and anorexia. A duodenal content
analysis revealed lamblia. What drug
should be prescribed?
A. Metronidazole
B. Chingamin
C. Rifampicin
D. Isoniazid
E. Acyclovir
146. A 28-year-old female patient
consulted a gynecologist about sterility.
Examination revealed underdeveloped
ovaries and uterus, irregular menstrual
cycle. Analysis of the sex chromatin
revealed 2 Barr’s bodies in most somatic
cells. What chromosome disease is most
likely?
A. Triple X syndrome
B. Edwards’ syndrome
C. Patau’s syndrome
D. Klinefelter’s syndrome
E. Turner’s syndrome
147. A 1-year-old baby has been hospitali-
sed for body and limbs lesions. Exami-
 Krok 1 Medicine 2011
nation revealed carnitine deficiency in the
child’s muscles. A biochemical reason for
this pathology is the disorder of:
A. Transport of fatty acids to mitochondria
B. Regulation of Ca2+ rate in mitochondria
C. Substrate-linked phosphorylation
D. Utilization of lactic acid
E. Oxidative phosphorylation
148. During anesthetization a pati-
ent presented with symptoms of tonus
increase of parasympathetic nervous
system such as hypersalivation and
laryngospasm. What drug could have
prevented these undesirable effects?
A. Atropine sulphate
B. Adrenaline hydrochloride
C. Neostigmine
D. Analgin
E. Pyracetam
149. Some students developed myodynia
after continuous physical activity during
physical education. The reason for such
condition was accumulation of lactic acid
in the skeletal muscles. It was generated
in the students’ bodies after activation of
the following process:
A. Glycolysis
B. Gluconeogenesis
C. Pentose-phosphate cycle
D. Lipolysis
E. Glycogeny
150. A newborn develops dyspepsia
after the milk feeding. When the mi-
lk is substituted by the glucose solution
the dyspepsia symptoms disappear. The
newborn has the subnormal activity of the
following enzyme:
A. Lactase
B. Invertase
C. Maltase
D. Amylase
E. Isomaltase
151. A doctor asked a patient to breath
out fully after taking a normal breath.
What muscles contract during such
exhalation?
A. Abdominal muscles
B. External intercostal muscles
C. Diaphragm
D. Trapezius muscles
E. Pectoral muscles
152. On an electron micrograph a sci-
entist has identified a structure formed
17
by eight histone proteins and a part of
DNA molecule which makes about 1,75
revolutions around the molecules. Which
structure has been identified?
A. Nucleosoma
B. Elemetary fibril
C. Half-chromatid
D. Chromatid
E. Chromosome
153. A patient with massive burns
developed acute renal insufficiency
characterized by a significant and
rapid deceleration of glomerular fi-
ltration. What is the mechanism of its
development?
A. Reduction of renal blood flow
B. Damage of glomerular filter
C. Reduction of functioning nephron
number
D. Rise of pressure of tubular fluid
E. Renal artery embolism
154. A three-year-old child has had
marked diarrhea for three days. Immune
electron microscopy of his excrements
revealed bilayer pseudocovered capsid vi-
ruses that looked like small spoke wheels.
What viruses have been revealed?
A. Rotaviruses
B. Coxsackie viruses
C. ECHO viruses
D. Coronaviruses
E. Reoviruses
155. A male patient has fever and
enanthesis. As a result of the exami-
nation involving serological tests he has
been diagnosed with fasciola hepatica. It
was found out that the patient had been
infected through raw river water. Which
stage of fasciola life cycle is invasive for
humans?
A. Adolescaria
B. Metacercaria
C. Ovum
D. Miracidium
E. Cysticercus
156. A patient with high-titer antinuclear
antibodies died from progressing renal
impairment. Autopsy revealed mesangi-
oproliferative glomerulonephritis and
abacterial polypous endocarditis. There
was periarterial bulbar sclerosis in spleen
and productive proliferative vasculitis in
skin. What is the most likely diagnosis?
 Krok 1 Medicine 2011
A. Systemic lupus erythematosus
B. Nephrotic syndrome
C. Rheumatism
D. Dermatomyositis
E. Periarteritis nodosa
157. Electronic microphotography of
pulmonary alveole’s wall presents a big
cell. Its cytoplasm has a lot of mi-
tochondria, developed Golgi apparatus,
osmiophil lamellated corpuscles. What is
the main function of this cell?
A. It produces surfactant
B. It is a component of blood-air barrier
C. It warms the air
D. It purifies the air
E. It absorbs microorganisms
158. A patient has food poisoning.
Laboratory analysis revealed a culture
of anaerobic gram-positive spore-forming
bacteria. What is the most likely kind of
the isolated causative agent?
A. C. perfringens
B. Proteus vulgaris
C. P. mirabilis
D. Vibrio parahemolyticus
E. Esherichia coli
159. An animal has an increased tonus
of extensor muscles. This the result
of intensified information transmissi-
on to the motoneurons of the spinal
cord through the following descending
pathways:
A. Vestibulospinal
B. Medial corticospinal
C. Reticulospinal
D. Rubrospinal
E. Lateral corticospinal
160. A 70-year-old male patient died from
acute coronary insufficiency. He had knee
joint swelling, gonycampsis and gonalgia
during his lifetime. Pathomorphologic
examination of the deformed joi-
nts and synovial membranes revealed
membrane hyperaemia with multiple
perivascular inflammatory infltrations
made by lymphocytes, plasmocytes
and macrophagocytes. There was an
accumulation of organized fibrin covering
some areas of synovium membrane and
looking like rice grains in the articular li-
quid. What is the most likely diagnosis?
18
A. Atrophic arthritis
B. Periarteritis nodosa
C. Ankylosing spondylitis
D. Tuberculous arthritis
E. Deforming arthrosis
161. 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:
A. Temporal
B. Postcentral gyrus
C. Parietal
D. Occipital
E. Frontal
162. A pregnant woman was registered
in an antenatal clinic and underwent
complex examination for a number of
infections. Blood serum contained IgM
to the rubella virus. What is this result
indicative of?
A. Of primary infection
B. Of a chronic process
C. The woman is healthy
D. Of exacerbation of a chronic disease
E. Of recurring infection with rubella virus
163. A patient with tuberculosis di-
ed from progressing cardiopulmonary
decompensation. Autopsy in the region of
the right lung apex revealed a cavity 5 cm
in diameter communicating with lumen
of a segmental bronchus. On the insi-
de cavity walls are covered with caseous
masses with epithelioid and Langhans
cells beneath them. What morphological
form of tuberculosis is it?
A. Acute cavernous tuberculosis
B. Tuberculoma
C. Caseous pneumonia
D. Infiltrative tuberculosis
E. Acute focal tuberculosis
164. Vomiting matters of a patient
suspected of having cholera were deli-
vered to the bacteriological laboratory.
The material was used for preparing a
"hanging drop"specimen. What type of
microscopy will be applied for identificati-
on of the causative agent by its mobility?
A. Phase-contrast microscopy
B. Electron microscopy
C. Immune and electron microscopy
D. Fluorescence microscopy
E. Immersion microscopy
165. A patient with enteritis accompanied
 Krok 1 Medicine 2011
by massive diarrhea has low water rate
in the extracellular space, high water rate
inside the cells and low blood osmolari-
ty. What is such disturbance of water-
electrolytic metabolism called?
A. Hypo-osmolar hypohydration
B. Hyperosmolar hypohydration
C. Osmolar hypohydration
D. Hypo-osmolar hyperhydration
E. Hyperosmolar hyperhydration
166. Examination of a 6-month-old child
revealed a delay in closure of the occipi-
tal fontanelle. When should it normally
close?
A. Until 3 months
B. Before the child is born
C. Until 6 months
D. Until the end of the first year of life
E. Until the end of the second year of life
167. A newborn child was found to have
reduced intensity of sucking, frequent
vomiting, hypotonia. Urine and blood
exhibit increased concentration of citrulli-
ne. What metabolic process is disturbed?
A. Ornithinic cycle
B. Tricarboxylic acid cycle
C. Glycolysis
D. Glyconeogenesis
E. Cori cycle
168. A male patient has been diagnosed
with acute radiation disease. Laboratory
examination revealed a considerable
reduction of platelet serotonin level. The
likely cause of platelet serotonin reducti-
on is the disturbed metabolism of the
following substance:
A. 5-oxytryptofane
B. Tyrosine
C. Histidine
D. Phenylalanine
E. Serine
169. In course of a conditional experiment
the development of mesenchyma cells
was completely inhibited. Development
of the following muscular tissue will be di-
sturbed:
A. Smooth muscular tissue
B. Neural muscular tissue
C. Epidermal muscular tissue
D. Cardiac muscular tissue
E. Skeletal muscular tissue
170. A histologic specimen shows an
organ’s parenchyma which is presented
19
by lymphoid tissue making some lymph
nodes. The nodes are located diffusi-
vely and contain a central artery. What
anatomic formation might have such
morphological structure?
A. Spleen
B. Red bone marrow
C. Thymus
D. Tonsil
E. Lymph node
171. A victim with a head trauma in the
temporal region has been diagnosed with
epidural hematoma. What artery is most
likely to be damaged?
A. Medial membranous artery
B. Medial cerebral artery
C. Superficial temporal artery
D. Anterior membranous artery
E. Posterior auricular artery
172. A child has mental and physical
retardation, grave damage of internal
connective tissue. Urine analysis reveals
keratan sulfates. What metabolic process
is disturbed?
A. Glycosaminoglycans
B. Collagen
C. Elastin
D. Fibronectin
E. Hyaluronic acid
173. A tooth extraction in a patient
with chronic persistent hepatitis was
complicated with prolonged hemorrhage.
What is the reason for the haemorrhagic
syndrome?
A. Decrease in thrombin production
B. Increase in thromboplastin production
C. Decrease in fibrin production
D. Increase in fibrinogen synthesis
E. Fibrinolysis intensification
174. Sex chromosomes of a woman didn’t
separate and move to the opposite poles
of a cell during gametogenesis (meiosis).
The ovum was impregnated with a normal
spermatozoon. Which chromosomal di-
sease can be found in her child?
A. Turner’s syndrome
B. Down’s syndrome
C. Patau’s syndrome
D. Edwards’ syndrome
E. Cat cry syndrome
175. A female patient was administered
loratadine for allergic cheilitis treatment.
What is the mechanism of the drug’s acti-
 Krok 1 Medicine 2011 20

on? 180. A patient consulted a doctor about

loss of taste sensitivity on the tongue root.
A. It blocks the activity of H1 histamine The doctor revealed that it is caused by
receptors nerve affection. Which nerve is it?
B. It blocks the adrenergic receptors
C. It stimulates the activity of monoamine A. Glossopharyngeal
oxidase B. Vagus nerve
D. It inhibits the activity of Na,K-ATP C. Facial nerve
E. It inhibits the activity of choline esterase D. Superlaryngeal nerve
E. Trigeminal nerve
176. Ultramicroscopical examination of
"dark"hepatocyte population in the cell 181. Which muscle contraction will be
cytoplasm detected a developed granular observed in the upper extremity duri-
endoplasmic reticulum. What function has ng holding (but not moving) a load in a
this organella in these cells? certain position?
A. Synthesis of blood plasma proteins A. Isometric
B. Carbohydrate synthesis B. Isotonic
C. Deintoxicative function C. Auxotonic
D. Bile production D. Concentric
E. Calcium ion depositing E. Excentric
177. A doctor prescribed a cephalosporin 182. An older woman has been hospitali-
antibiotic to the patient after appendectomy sed for acute pain and edema of the right
for infection prevention. Antimicrobial hip joint that appered after a fall. Objecti-
activity of this group of antibiotics is based vely: the hip is adduced inwards, hip joi-
upon the disturbance of the following nt movements are impaired. The patient
process: is most likely to have a fracture of the
following bone or bone part:
A. Microbial wall formation
B. Nucleic acid synthesis A. Femoral neck
C. Ribosome protein synthesis B. Shaft of femur
D. Energy metabolism C. Condyle of femur
E. Choline esterase block D. Pubic bone
E. Ischial bone
178. A patient underwent an extraction of
a part of a CNS structures by medical indi- 183. A 45-year-old woman has breast
cations. As a result of the extraction the cancer. Her left arm has symptoms of
patient developed atony, astasia, intenti- lymphatic system insufficiency - limb
on tremor, ataxy and adiadochokinesis. edema, lymph node enlargement. What
Which part of CNS structure had been form of lymphatic circulation insufficiency
extracted? is it?
A. Cerebellum A. Mechanic insufficiency
B. Amygdaloid corpus B. Dynamic insufficiency
C. Hippocamp C. Resorption insufficiency
D. Basal ganglions D. Combined insufficiency
E. Limbic system E. -
179. A patient has been diagnosed with 184. Study of conversion of a food colouri-
influenza. His condition became drasti- ng agent revealed that neutralization of
cally worse after taking antipyretic drugs. this xenobiotic takes place only in one
His consciousness is confused, AP is 80/50 phase - microsomal oxydation. Name a
mm Hg, Ps is 140/m, body temperature component of this phase:
droped down to 35, 8o C. What complicati-
on developed in this patient? A. Cytochrome Р-450
B. Cytochrome B
A. Collapse C. Cytochrome C
B. Hyperthermia D. Cytochrome A
C. Hypovolemia E. Cytochrome oxidase
D. Acidosis
E. Alkalosis 185. While performing an inguinal canal
operation on account of hernia a surgeon
 Krok 1 Medicine 2011
damaged the canal’s contents. What
exactly was damaged?
A. Funiculus spermaticus
B. Urarchus
C. Lig. teres uteri
D. Lig. inguinalе
E. -
186. A patient with myocardial infarcti-
on was admitted to the cardiological
department. For pain relief it was deci-
ded to potentiate fentanyl action wi-
th a neuroleptic. Which of the followi-
ng neuroleptics is the most suitable for
neuroleptanalgesia?
A. Droperidol
B. Aminazine
C. Triftazine
D. Haloperidol
E. Sulpiride
187. A 25-year-old man has spent a long ti-
me in the sun under high air humidity. As
a result of it his body temperature rose up
to 39oC. What pathological process is it?
A. Hyperthermia
B. Infectious fever
C. Hypothermia
D. Noninfectious fever
E. Burn disease
188. A 26-year-old man is in the torpid
shock phase as a result of a car accident.
In blood: 3, 2 · 109 /l. What is the leading
mechanism of leukopenia development?
A. Redistribution of leukocytes in
bloodstream
B. Leikopoiesis inhibition
C. Disturbed going out of mature
leukocytes from the marrow into the
blood
D. Lysis of leukocytes in the blood-forming
organs
E. Intensified elimination of leukocytes
from the organism
189. A patient consulted a doctor about a
sensation of imbalance which appeared
after a trauma. Which nerve is damaged?
A. Vestibulocochlear nerve
B. Trigeminal nerve
C. Facial nerve
D. Intermediate nerve
E. Vagus nerve
190. An alcoholic has alcoholic psychosis
with evident psychomotor agitation. What
neuroleptic drug should be administered
21
for emergency care?
A. Aminazine
B. Diazepam
C. Sodium bromide
D. Reserpine
E. Halothane
191. A patient who has been treated in
a neural clinic and has been taking a
sedative for a long time got the followi-
ng complication: cough, rhinitis, epiphora.
What drug caused these disturbances?
A. Sodium bromide
B. Diazepam
C. Valerian
D. Phenazepam
E. Reserpine
192. The liver puncture biopsy of a patient
with hepatocellular insufficiency revealed
hydropic and ballooning degenerationof
hepatocytes, necrosis of certain cells,
presence of Kaunsilmen’s bodies. Portal
and lobular stroma were infiltrated mostly
with lymphocytes and macrophages
as well as with a small number of
polymorphonuclear lymphocytes. What is
the most likely diagnosis?
A. Acute viral hepatitis
B. Chronic persistent hepatitis
C. Chronic aggressive hepatitis
D. Autoimmune hepatitis
E. Alcoholic hepatitis
193. In order to accelerate healing of a
radiation ulcer a vitamin drug was admi-
nistered. What drug is it?
A. Retinol acetate
B. Retabolil
C. Prednisolone
D. Levamisole
E. Methyluracil
194. After inoculation of the material
obtained from the pharynx of an angina
patient onto the blood-tellurite agar, grey
colonies could be observed. They were
4-5 mm in diameter, radially striated (in
form of rosettes). Microscopical exami-
nation revealed gram-positive bacilli wi-
th clavate swollen ends arranged in form
of wide-spread fingers. Identify these mi-
croorganisms:
 Krok 1 Medicine 2011
A. Diphtheria corynebacteria
B. Clostridium botulinum
C. Diphtheroids
D. Streptococci
E. Streptobacilli
195. Cytogenetic examination of a patient
with reproductive dysfunction revealed
normal karyotype 46 ХY in some cells, but
most cells have karyotype of Klinefelter’s
syndrome - 47 ХХY. Such cell heterogeni-
ty is called:
A. Mosaicism
B. Inversion
C. Transposition
D. Duplication
E. Monomorphism
196. A patient presents with acne and
inflammatory alterations of facial skin.
Microscopial investigation of lesion foci
has revealed live arthropods sized 0,2-
0,5 mm. They have prolate vermiform
form and four pairs of thin short limbs
located in the middle part of the body.
The revealed arthropods cause:
A. Demodicosis
B. Scabies
C. Pediculosis
D. Phthiriasis
E. Dermamyiasis
197. Surgical approach to the thyroid
gland from the transverse (collar)
approach involves opening of interaponeurotic ssue with prevailing collagen fibres. What
suprasternal space. What anatomic
structure localized in this space is
dangerous to be damaged?
A. Jugular venous arch
B. External jugular vein
C. Subclavicular vein
D. Inferior thyroid arthery
E. Superior thyroid arthery
22
198. An injured person was delivered to
the hospital with a penetrating wound in
the left lateral region of abdomen. What
part of the large intestine is most likely
damaged?
A. Colon descendens
B. Colon ascendens
C. Colon transverses
D. Caecum
E. Rectum
199. A 4-year-old child presents with
general weakness, sore throat and degluti-
tive problem. After his examination a
doctor suspected diphtheria and sent the
material to the bacteriological laboratory.
In order to determine the diphtheria
causative agent the material should be
inoculated into the following differenti-
al diagnostic medium:
A. Blood tellurite agar
B. Endo’s agar
C. Ploskyrev’s agar
D. Sabouraud’s agar
E. Levenshtein-Yessen agar
200. Examination of the anterior abdomi-
nal wall of a pregnant woman revealed
a tumour-like formation that arose on
the spot of a tumour that was removed
two years ago. The neoplasm was well-
defined, dense, 2х1 cm large. Histological
examination revealed that the tumour was
composed of differentiated connective ti-
tumour might be suspected?
A. Desmoid
B. Lipoma
C. Fibrosarcoma
D. Hibernoma
E. Leiomyoma
 Krok 1 Medicine 2012
1. A man suffering from a hereditary
disease married a healthy woman. They
got 5 children, three girls and two boys.
All the girls inherited their father’s di-
sease. What is the type of the disease
inheritance?
A. Dominant, X-linked
B. Autosomal recessive
C. Asutosomal dominant
D. Y -linked
E. Recessive, X-linked
2. Characteristic sign of glycogenosis
is muscle pain during physical work.
Blood examination reveals usually
hypoglycemia. This pathology is caused
by congenital deficiency of the following
enzyme:
A. Glycogen phosphorylase
B. Glucose 6-phosphate dehydrogenase
C. Alpha amylase
D. Gamma amylase
E. Lysosomal glycosidase
3. During an operation a patient got
injection of muscle relaxant dithylinum.
Relaxation of skeletal muscles and inhibi-
tion of respiration lasted two hours. This
condition was caused by absence of the
following enzyme in blood serum:
A. Butyrylcholin esterase
B. Catalase
C. Acetylcholinesterase
D. Glucose 6-phosphatase
E. Glutathione peroxidase
4. A couple has a son with haemophilia.
The parents are healthy but the maternal
grandfather also has haemophilia. Specify
the type of inheritance:
A. Recessive sex-linked
B. Recessive autosomal
C. Dominant sex-linked
D. Semidominance
E. Autosomal dominant
5. Examination of newborns in one of
the Ukrainian cities revealed a baby wi-
th phenylketonuria. The baby’s parents
don’t suffer from this disease and have
two other healthy children. Specify
the most likely parents’ genotype with
phenylketonuria gene:
A. Аа х Аа
B. АА х аа
C. аа х аа
D. Аа х аа
E. Аа х АА
1
6. A patient has a right-sided fracture in
the region of the frontal third of mandible
accompanied by a haematoma in the regi-
on of chin. It is caused by the injury of the
following artery:
A. Mental
B. Inferior labial
C. Lingual
D. Facial
E. Palatine
7. A 46 year old female patient has a conti-
nuous history of progressive muscular
(Duchenne’s) dystrophy. Which blood
enzyme changes will be of diagnostic
value in this case?
A. Creatine phosphokinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate cyclase
8. As a result of a cold a patient has the
abnormal pain and temperature sensitivi-
ty of the frontal 2/3 of his tongue. Which
nerve must have been damaged?
A. Trigeminus
B. Sublingual
C. Accessory
D. Vagus
E. Glossopharyngeal
9. A 60 year old patient has impaired
perception of high-frequency sounds.
These changes were caused by damage of
the following auditory analyzer structures:
A. Main cochlea membrane near the oval
window
B. Main cochlea membrane near the
helicotrema
C. Eustachian tube
D. Middle ear muscles
E. Tympanic membrane
10. After a trauma of soft tissues in the
region of the posterior sorface of medi-
al condyle of humerus a patient has got
a skin prickle of medial forearm surface.
Which of the listed nerves is located in the
affected region?
A. N.ulnaris
B. N.musculocutaneu
C. N.dorsalis scapularis
D. N.subscapularis
E. N.radialis
11. A boy has fallen down from a tree.
Now he finds it difficult to abduct his arm
 Krok 1 Medicine 2012
into horizontal position. Which muscle is
most likely to be injured?
A. M.deltoideus
B. M.triceps brachii
C. M.anconeus
D. M.coracobrachialis
E. M.supinator
12. A female patient with a tumour of
pancreas has developed mechanic jaundi-
ce resulting from compression of a bile-
excreting duct. Which duct is compressed?
A. Ductus choledochus
B. Ductus cysticus
C. Ductus hepaticus communis
D. Ductus hepaticus dexter
E. Ductus hepaticus sinister
13. A 28 year old woman has been di-
agnosed with extrauterine pregnancy
complicated by tha fallopian tube rupture.
The blood is most likely to penetrate the
following peritoneal space:
A. Rectouterine
B. Vesicouterine
C. Right mesenteric sinus
D. Left mesenteric sinus
E. Intersigmoid sinus
14. Patients with similar complaints appli-
ed to the doctor: weakness, pain in the
intestines, disorder of GIT. Examination
of the faeces revealed that one patient wi-
th four nucleus cysts should be hospitali-
zed immidiately. For what protozoa are
such cysts typical?
A. Dysenteric amoeba
B. Intestinal amoeba
C. Balantidium
D. Trichomonas
E. Lamblia
15. Autopsy of a 58 year old man revealed
that bicuspid valve was deformed, thi-
ckened and unclosed. Microscopically:
foci of collagen fibrilla are eosinophi-
lic, react positively to fibrin. The most
probably it is:
A. Fibrinoid swelling
B. Fibrinous inflammation
C. Mucoid swelling
D. Hyalinosis
E. Amyloidosis
16. Chronic inflammation and transformati-
on of the one-layer ciliated epitheli-
um into multiple-layers flat epithelium
was revealed in the thickened mucous
2
membrane of the bronchus bioptate of
the patient with smoke abuse. Which of
the processes is the most likely?
A. Metaplasia
B. Hyperplasia of the epithelium
C. Squamous cancer
D. Leucoplacia
E. Epithelium hypertrophy
17. During postembryonal haemopoiesis
in the red bone marrow the cells of one
of the cellular differons demonstrate a
gradual decrease in cytoplasmic basophi-
lia as well as an increase in oxyphilia,
the nucleus is being forced out. Such
morphological changes are typical for the
following haemopoiesis type:
A. Erythropoiesis
B. Lymphopoiesis
C. Neutrophil cytopoiesis
D. Eosinophil cytopoiesis
E. Basophil cytopoiesis
18. Students who are taking examinations
often have dry mouth. The mechanism
that causes this state is the realization of
the following reflexes:
A. Conditioned sympathetic
B. Unconditioned parasympathetic
C. Conditioned parasympathetic
D. Unconditioned sympathetic
E. Unconditioned peripheral
19. The temperature of the ambient envi-
ronment is 38o C and relative air humidity
is 50%. What ways of heat emission provi-
de maintaining a constant temperature of
the human body?
A. Evaporation
B. Radiation
C. Heat conduction
D. Convection
E. Convection and conduction
20. A microspecimen of heart shows
rectangular cells from 50 to 120 mcm
large with central position of nucleus,
developed myofibrils. The cells are
connected by intercalated discs. These
cells are responsible for the following
function:
A. Function of heart contractions
B. Function of impulse conduction
C. Endocrine
D. Protective
E. Regeneratory
21. A 30 year old woman has subnormal
 Krok 1 Medicine 2012 3

concentration of enzymes in the

pancreatic juice. This might be caused by A. Lymphogranulomatosis
the hyposecretion of the following gastroi- B. Acute lympholeucosis
ntestinal hormone: C. Chronic lympholeucosis
D. Berkitt’s lymphoma
A. Cholecystokinin-pancreozymin E. Fungoid mycosis
B. Somatostatin
C. Secretin 26. A child has abnormal formation of
D. Gastro-inhibiting peptide tooth enamel and dentin as a result of low
E. Vaso-intestinal peptide concentration of calcium ions in blood.
Such abnormalities might be caused by
22. A female patient consulted a deficiency of the following hormone:
physician about digestive disorder,
extended abdominal pain. Examination A. Parathormone
revealed drastic decrease in hemoglobin B. Thyrocalcitonin
concentration. It is known from the C. Thyroxin
anamnesis that while living in the Far East D. Somatotropic hormone
the patient used to eat freshly-salted cavi- E. Triiodothyronine
ar. Some relatives living with her had the
similar condition. What is the most likely 27. A sportsman was examined after an
diagnosis? intensive physical activity. The examinati-
on revealed disorder of movement coordi-
A. Diphyllobothriasis nation but the force of muscle contracti-
B. Echinococcosis ons remained the same. It can be explai-
C. Teniasis ned by retarded speed of excitement
D. Trichiniasis conduction through:
E. Ascaridiasis
A. Central synapses
23. A patient has a trauma of sternoclei- B. Neuromuscular synapses
domastoid muscle. This caused a decrease C. Efferent nerves
in value of the following indicator of D. Afferent nerves
external respiration: E. Conduction tracts
A. Inspiratory reserve volume 28. After a long training session
B. Expiratory reserve volume a sportsman has developed fatigue
C. Respiratory capacity accompanied by abrupt performance
D. Residual volume decrement. What link of the reflex arch
E. Functional residual lung capacity was the fatigue initiated in?
24. A month after surgical constriction A. Nerve centres
of rabbit’s renal artery the considerable B. Afferent conductor
increase of systematic arterial pressure C. Receptors
was observed. What of the following D. Efferent conductor
regulation mechanisms caused the ani- E. Muscles
mal’s pressure change?
29. Blood minute volume of a 30 year old
A. Angiotensin-II woman at rest is 5 l/m. What blood volume
B. Vasopressin is pumped through the pulmonary vessels
C. Adrenaline per minute?
D. Noradrenaline
E. Serotonin A. 5 l
B. 3,75 l
25. Microscopic examination of the C. 2,5 l
enlarged neck gland of a 14 year old D. 2,0 l
girl revealed destruction of the ti- E. 1,5 l
ssue structure of the node, absence of
the lymph follicles, sclerotic areas and 30. After a tourniquet application a
necrosis foci, cell constitution of the node patient was found to have petechial
is polymorphous, lymphocites, eosinophi- haemorrhages. The reason for it is the
les, big atypical cells with multilobular dysfunction of the following cells:
nuclei (Beresovsky-Sternberg cells) and
mononuclear cells of the large size are
present. What is the most likely diagnosis?
 Krok 1 Medicine 2012 4

A. Platelets A. Choline
B. Eosinophils B. DOPA
C. Monocytes C. Cholesterol
D. Lymphocytes D. Acetoacetate
E. Neutrophils E. Linoleic acid
31. A patient under test was subjected to 36. Vegetative abnormalities in the sleep,
a moderate physical stress. His minute heat regulation, all kinds of metabolism,
blood volume amounted 10 l/min. What diabetes insipidus are developing in the
blood volume was pumped through his patient due to grouth of the tumour in
lung vessels every minute? the III ventricle of brain. Irritation of the
nucleus of what part of the brain can cause
A. 10 l/min this symptoms?
B. 5 l/min
C. 4 l/min A. Hypothalamus
D. 6 l/min B. Cerebral peduncles (cruces cerebri)
E. 7 l/min C. Mesencephalic tegmentum
D. Pons cerebelli
32. A patient presents with the following E. Medulla
motor activity disturbances: tremor, ataxia
and asynergia movements, dysarthria. The 37. A patient complains about dyspnea
disturbances are most likely to be locali- provoked by the physical activity. Clini-
zed in: cal examination revealed anaemia and
presence of the paraprotein in the zone
A. Cerebellum of gamma-globulins. To confirm the
B. Basal ganglions myeloma diagnosis it is necessary to
C. Limbic system determine the following index in the pati-
D. Brainstem ent’s urine:
E. Medulla oblongata
A. Bence Jones protein
33. A man has a considerable decrease B. Bilirubin
in diuresis as a result of 1,5 l blood loss. C. Haemoglobin
The primary cause of such diuresis di- D. Ceruloplasmin
sorder is the hypersecretion of the followi- E. Antitrypsin
ng hormone:
38. Examination of a child who hasn’t
A. Vasopressin got fresh fruit and vegetables during wi-
B. Corticotropin nter revealed numerous subcutaneous
C. Natriuretic hemorrhages, gingivitis, carious cavities in
D. Cortisol teeth. What vitamin combination should
E. Parathormone be prescribed in this case?
34. The patient with thymoma (thymus A. Ascorbic acid and rutin
gland tumour) has cyanosis, extention of B. Thiamine and pyridoxine
subcutaneous venous net and edema of C. Folic acid and cobalamin
the soft tissues of face, neck, upper part D. Riboflavin and nicotinamide
of the trunk and upper extremities. What E. Calciferol and ascorbic acid
venous trunk is pressed with tumour?
39. A 2 year old child with mental
A. Superior vena cava and physical retardation has been deli-
B. External jugular vein vered to a hospital. He presents with
C. Clavicular vein frequent vomiting after having meals.
D. Internal jugular vein There is phenylpyruvic acid in urine. Whi-
E. Frontal jugular vein ch metabolism abnormality is the reason
for this pathology?
35. An experimantal animal that was kept
on protein-free diet developed fatty li- A. Amino-acid metabolism
ver infiltration, in particular as a result B. Lipidic metabolism
of deficiency of methylating agents. This C. Carbohydrate metabolism
is caused by disturbed generation of the D. Water-salt metabolism
following metabolite: E. Phosphoric calcium metabolism
40. 46 chromosomes were revealed on
 Krok 1 Medicine 2012
karyotype examination of the 5 year old
girl. One of the 15th pair of chromosomes
is longer than usual due to connected
chromosome from the 21 pair. What type
of mutation does this girl have?
A. Translocation
B. Deletion
C. Inversion
D. Insufficiency
E. Duplication
41. A 62 year old woman complai-
ns of frequent pain attacks in the
area of her chest and backbone, rib
fractures. Her doctor suspected myeloma
(plasmocytoma). What of the following
laboratory characteristics will be of the
greatest diagnostic importance?
A. Paraproteinemia
B. Hyperalbuminemia
C. Proteinuria
D. Hypoglobulinemia
E. Hypoproteinemia
42. Before the cells can utilize the glucoze,
it is first transported from the extracellular
space through the plasmatic membrane
inside theml. This process is stimulated by
the following hormone:
A. Insulin
B. Glucagon
C. Thyroxin
D. Aldosterone
E. Adrenalin
43. Parodontitis is treated with calcium
preparations and a hormone that sti-
mulates tooth mineralization and inhibits
tissue resorption. What hormone is it?
A. Calcitonin
B. Parathormone
C. Adrenalin
D. Aldosterone
E. Thyroxine
44. A child has an acute renal failure.
What biochemical factor found in saliva
can confirm this diagnosis?
A. Increase in urea concentration
B. Increase in glucose concentration
C. Decrease in glucose concentration
D. Increase in concentration of higher fatty
acids
E. Decrease in nucleic acid concentration
45. After implantation of a cardiac valve a
young man constantly takes indirect anti-
coagulants. His state was complicated by
5
hemorrhage. What substance content has
decreased in blood?
A. Prothrombin
B. Haptoglobin
C. Heparin
D. Creatin
E. Ceruloplasmin
46. After severe viral hepatitis a 4 year
old boy presents with vommiting, occasi-
onal loss of consciousness, convulsions.
Blood test revealed hyperammoniemia.
Such condition is caused by a disorder of
the following biochemical hepatic process:
A. Disorder of ammonia neutralization
B. Disorder of biogenic amines neutrali-
zation
C. Protein synthesis inhibition
D. Activation of amino acid decarboxylati-
on
E. Inhibition of transamination enzymes
47. Having helped to eliminate
consequences of a failure at a nuclear
power plant, a worker got an irradiati-
on doze of 500 roentgen. He complai-
ns of headache, nausea, dizziness. What
changes in leukocytes quantity can be
expected 10 hours after irradiation?
A. Neutrophilic leukocytosis
B. Lymphocytosis
C. Leukopenia
D. Agranulocytosis
E. Leukemia
48. Bacterioscopic examination of a smear
from the pharynx of a diphtheria suspect
revealed bacilli with volutine granules.
What etiotropic drug should be chosen
in this case?
A. Antidiphtheritic antitoxic serum
B. Bacteriophage
C. Diphtheritic anatoxin
D. Eubiotic
E. Interferon
49. A patient with a history of
chronic glomerulonephritis presents
with azotemia, oliguria, hypo- and
isosthenuria, proteinuria. What is the
leading factor in the pathogenesis of these
symptoms development under chronic
renal failure?
 Krok 1 Medicine 2012
A. Mass decrease of active nephrons
B. Intensification of glomerular filtration
C. Tubular hyposecretion
D. Disturbed permeability of glomerular
membranes
E. Intensification of sodium reabsorption
50. After an attack of bronchial asthma a
patient had his peripheral blood tested.
What changes can be expected?
A. Eosinophilia
B. Leukopenia
C. Lymphocytosis
D. Thrombocytopenia
E. Erythrocytosis
51. A 70 year old female patient was di-
agnosed with fracture of left femoral neck
accompanied by disruption of ligament of
head of femur. The branch of the followi-
ng artery is damaged:
A. Obturator
B. Femoral
C. External iliac
D. Inferior gluteal
E. Internal pudendal
52. ECG of a patient shows prolongation
of T-wave. This is caused by deceleration
in ventricles of:
A. Repolarization
B. Depolarization and repolarization
C. Depolarization
D. Contraction
E. Relaxation
53. After the traumatic tooth extraction
a patient is complaining of acute, dull,
poorly-localized pain in gingiva, body
temperature rise up to 37, 5oC. The pati-
ent has been diagnosed with alveolitis.
Specify the kind of pain in this patient:
A. Protopathic
B. Epicritic
C. Visceral
D. Heterotopic
E. Phantom
54. A 50 year old patient suffers from
essential hypertension. After a physical
stress he experienced muscle weakness,
breathlessness, cyanosis of lips, skin and
face. Respiration was accompanied by
distinctly heard bubbling rales. What
mechanism underlies the development of
this syndrome?
6
A. Acute left-ventricular failure
B. Chronic right-ventricular failure
C. Chronic left-ventricular failure
D. Collapse
E. Cardiac tamponade
55. A 5 year old child has been diagnosed
with acute right distal pneumonia.
Sputum inoculation revealed that the
causative agent is resistant to penicillin,
but it is senstive to macrolides. What drug
should be prescribed?
A. Azithromycin
B. Tetracycline
C. Gentamycin
D. Streptomycin
E. Ampicillin
56. A patient suffering from chronic
myeloleukemia has got the followi-
ng symptoms of anemia: decreased
number of erythrocytes and low
haemoglobin concentration, oxyphilic
and polychromatophilic normocytes, mi-
crocytes. What is the leading pathogenetic
mechanism of anemia development?
A. Substitution of haemoblast
B. Intravascular hemolysis of erythrocytes
C. Deficiency of vitamin B12
D. Reduced synthesis of erythropoietin
E. Chronic haemorrhage
57. A patient with obliterating endarteri-
tis underwent ganglionic sympathectomy.
What type of arterial hyperaemia should
have developed as a result of the surgery?
A. Neuroparalytic
B. Neurotonic
C. Metabolic
D. Functional
E. Reactive
58. Autopsy of a woman with cerebral
atherosclerosis revealed in the left
cerebral hemisphere a certain focus that
is presented by flabby, anhistic, greyish
and yellowish tissue with indistinct edges.
What pathological process is the case?
A. Ischemic stroke
B. Multifocal tumor growth with cystic
degeneration
C. Multiple foci of fresh and old cerebral
hemorrhage
D. Focal encephalitis
E. Senile encephalopathy
59. A patient suffering from chronic
hyperacidic gastritis takes an antacid
drug for heartburn elimination. After its
 Krok 1 Medicine 2012
ingestion the patient feels better but at the
same time he has a sensation of stomach
swelling. Which of the following drugs mi-
ght be the cause of such side effect?
A. Sodium hydrocarbonate
B. Magnesium oxide
C. Magnesium trisilicate
D. Aluminium hydrooxide
E. Pepsin
60. A 63 year old patient with collapse
presentations was delivered to the
emergency hospital. A physician has
chosen noradrenalin against hypotension.
What is its mechanism of action?
A. Activation of α1 -adrenoreceptors
B. Activation of serotonin receptors
C. Activation of β-adrenoreceptors
D. Activation of dopamine receptors
E. Block of M-cholinoreceptors
61. Autopsy of a man who had
tuberculosis revealed a 3x2 cm large cavi-
ty in the superior lobe of the right lung.
The cavity was interconnected with a
bronchus, its wall was dense and consi-
sted of three layers: the internal layer
was pyogenic, the middle layer was made
by tuberculous granulation tissue and the
external one was made by connective ti-
ssue. What is the most likely diagnosis?
A. Fibrous cavernous tuberculosis
B. Fibrous focal tuberculosis
C. Tuberculoma
D. Acute focal tuberculosis
E. Acute cavernous tuberculosis
62. A patient suffering from syphilis has
been treated with bismuth preparations.
As a result of it some grey spots turned
up on the mucous membrane of the oral
cavity; nephropathy symptoms were also
present. What drug should be used for
treatment of bismuth intoxication?
A. Unithiol
B. Methylene blue
C. Naloxone
D. Bemegride
E. Nalorphine
63. Autopsy of a man who died from
ethylene glycol poisoning revealed that
his kidneys are a little bit enlarged,
edematic; their capsule can be easily
removed. Cortical substance is broad and
light-grey. Medullary substance is dark-
red. What pathology had this man?
7
A. Necrotic nephrosis
B. Acute pyelonephritis
C. Acute glomerulonephritis
D. Acute tubular-interstitial nephritis
E. Lipoid nephrosis
64. A 44 year old woman complains of
general weakness, heart pain, significant
increase of body weight. Objectively:
moon face, hirsutism, AP is 165/100 mm
Hg, height - 164 cm, weight - 103 kg; the
fat is mostly accumulated on her neck,
thoracic girdle, belly. What is the main
pathogenetic mechanism of obesity?
A. Increased production of glucocorticoids
B. Reduced production of thyroid
hormones
C. Increased insulin production
D. Reduced glucagon production
E. Increased mineralocorticoid production
65. A man with a long-term history of
bronchial asthma died from asphyxia.
Histological examination of his lungs
revealed that the lumens of bronchioles
and minor bronchi contained a lot of
mucus with some eosinophils. There was
also sclerosis of interalveolar septa, di-
latation of alveole lumens. What mechani-
sm accounts for the development of
hypersensitivity reaction?
A. Reagine reaction
B. Cytotoxic reaction
C. Immune complex reaction
D. Lymphocyte-mediated cytolysis
E. Granulomatosis
66. A 36 year old female patient has a hi-
story of collagen disease. Urine analysis is
likely to reveal an increased concentrati-
on of the following metabolite:
A. Oxyproline
B. Indican
C. Creatinine
D. Urea
E. Urobilinogen
67. Bacterioscopy of nasopharyngeal
mucus taken from a 2,5 year old chi-
ld with nasopharyngitis revealed gram-
positive diplococci looking like coffee
grains. What organs of the child are most
likely to be affected if these microorgani-
sms penetrate the blood?
 Krok 1 Medicine 2012
A. Brain tunics
B. Cardiac valves
C. Renal glomeruli
D. Urogenital tracts
E. Lymph nodes
68. Histologic analysis of uterus mucous
membrane revealed twisting glands,
serrated and spinned, they were extended
by stroma growth with proliferation of its
cells. Formulate a diagnosis:
A. Glandular hyperplasia of endometrium
B. Acute endometritis
C. Leiomyoma
D. Cystic mole
E. Placental polyp
69. Analysis of sputum taken from a pati-
ent with suspected pneumonia revealed
rather elongated gram-positive diplococci
with somewhat pointed opposite ends.
What microorganisms were revealed in
the sputum?
A. Streptococcus pneumoniae
B. Staphylococcus aureus
C. Klebsiella pneumoniae
D. Neisseria meningitidis
E. Neisseria gonorrhoeae
70. Serological diagnostics of infectious
diseases is based upon specific interacti-
on with antigenes. Specify the serologi-
cal reaction that underlies adhesion of
microorganisms when they are affected
by specific antibodies in presence of an
electrolyte:
A. Agglutination reaction
B. Precipitation reaction
C. Complement-binding reaction
D. Hemadsorption reaction
E. Neutralization reaction
71. The immunoblot detected gp120
protein in the blood serum. This protein is
typical for the following disease:
A. HIV-infection
B. Virus B hepatitis
C. Tuberculosis
D. Syphilis
E. Poliomyelitis
72. HIV has gp41 and gp120 on its
surface interacts with target cells of
an organism. Which of the following
human lymphocyte antigens is gp120
complementary bound with?
8
A. CD 4
B. CD 3
C. CD 8
D. CD 19
E. CD 28
73. A 65 year old patient with chronic
heart failure has been taking digitoxin in
self-administered dosages for a long ti-
me. She was admitted to the hospital for
general health aggravation, arrhythmia,
nausea, reduced diuresis, insomnia. What
is the primary action to be taken?
A. To withhold digitoxin
B. To reduce digitoxin dosage
C. To administer strophanthine
intravenously
D. To administer digoxin
E. To give an intravenous injection of
calcium gluconate solution
74. A 20 year old patient complains of
morbid thirst and huperdiuresis (up to 10
l daily). Glucose concentration in blood is
normal but it is absent in urine. The pati-
ent has been diagnosed with diabetes insi-
pidus. What hormonal drug is the most
appropriate for management of this di-
sorder?
A. Vasopressin
B. Cortisol
C. Thyroxin
D. Oxytocin
E. Insulin
75. A patient has myocardial infarcti-
on with thrombosis of the left coronary
artery. What pharmocological preparation
group should be used to reestablish blood
flow?
A. Fibrinolysis activators
B. Narcotic analgesics
C. β-adrenergic blockers
D. Angiotensin-converting enzyme inhibi-
tors
E. Glucocorticoids
76. A nurse accidentally injected a nearly
double dose of insulin to a patient with di-
abetes mellitus. The patient lapsed into a
hypoglycemic coma. What drug should be
injected in order to help him out of coma?
A. Glucose
B. Lidase
C. Insulin
D. Somatotropin
E. Noradrenaline
77. A patient has a slowly healing fracture.
 Krok 1 Medicine 2012
What medicine can be used to accelerate
formation of connective tissue matrix?
A. Methyluracil
B. Prednisolone
C. Cyclophosphan
D. Methotrexate
E. Cyclosporine
78. From the group of children who were
eating sweet sappy watermelon two kids
developed the signs of poisoning: rapid
weakness, dizziness, headache, vomiting,
edema, tachycardia, cyanosis of mouth,
ears, tips of the fingers cyanosis. High
concentration of nitrates was detected.
What is the leading mechanism of the
pathogenesis of the poisoning in the two
children?
A. Insufficiency of met-Hb-reductase
B. Insufficiency of superoxiddismutase
C. Block cytochrome oxidase
D. Insufficiency glutathione pyroxidase
E. Insufficiency of catalase
79. As a result of a trauma a patient has
damaged anterior roots of spinal cord.
What structures have been affected?
A. Axons of motoneurons and axons of
neurons of lateral horns
B. Central processes of sensitive neurons
of spinal ganglions
C. Peripheral processes of sensitive spinal
ganglions
D. Axons of neurons of lateral horns
E. Dendrites of neurons of spinal ganglions
80. During a prophylactic medical exami-
nation a 7-year-old boy was diagnosed
with daltonism. His parents are healthy
and have normal colour vision, but his
grandfather on his mother’s side has the
same abnormality. What is the type of the
abnormality inheritance?
A. Recessive, sex-linked
B. Dominant, sex-linked
C. Semidominance
D. Autosomal recessive
E. Autosomal dominant
81. The contents of vesicles that appeared
on the mucous membrane of a patient
with variola was sent to a virological
laboratory. Which of the listed changes
were revealed during the smear mi-
croscopy?
9
A. Paschen bodies
B. Babes-Negri bodies
C. Guarnieri bodies
D. Babes-Ernst bodies
E. Syncytium
82. Vitamin A together with specific
cytoreceptors penetrates through the
nuclear membranes, induces transcripti-
on processes that stimulate growth and
differentiation of cells. This biological
function is realized by the following form
of vitamin A:
A. Trans-retinoic acid
B. Trans-retinal
C. Cis-retinal
D. Retinol
E. Carotin
83. In order to determine toxigenicity of
diphtheria bacilli a strip of filter paper
impregnated with antitoxic diphtherial
serum was put on the dense nutrient medi-
um. There were also inoculated a mi-
crobal culture under examination and a
strain that is known to be toxigenic. If
the microbal culture under examinati-
on produces exotoxin, this wil result in
formation of:
A. Precipitin lines
B. Haemolysis zones
C. Zones of diffuse opacification
D. Zones of lecithovitellinous activity
E. Precipitin ring
84. A 63 year old male patient who
had been suffering from chronic di-
ffuse obstructive disease, pulmonary
emphysema, for 15 years died from cardi-
ac insufficiency. Autopsy revealed nutmeg
liver cirrhosis, cyanotic induration of ki-
dneys and spleen, ascites, edemata of
lower limbs. These changes of internal
organs are typical for the following di-
sease:
A. Chronic right-ventricular insufficiency
B. Acute right-ventricular insufficiency
C. Chronic left-ventricular insufficiency
D. Acute left-ventricular insufficiency
E. General cardiac insufficiency
85. A man who is riding the carousel
presents with increased heart rate, sweati-
ng, nausea. This condition is caused pri-
marily by the stimulation of the following
receptors:
 Krok 1 Medicine 2012
A. Vestibular ampullar
B. Proprioceptors
C. Vestibular otolithic
D. Auditory
E. Visual
86. A patient underwent esophagogastroduodenoscopy.
Analysis of the biopsy material enabled
doctors to diagnose him with heli-
cobacteriosis. What property of the
bacteria found in this patient had to be
obligatory taken into account during their
cultivation?
A. Microaerophilic ability
B. Presence of urease
C. Colonisation of gastral cells
D. Absence of spores and capsules
E. Presence of six polar flagella
87. A 38 year old man died all of a sudden.
Autopsy revealed myocardial infarction
in the posterior wall of the left ventri-
cle. What are the most likely alterations
in myocardiocyte structure that can be
revealed microscopically in the infarcti-
on focus?
A. Karyolysis
B. Adipose degeneration
C. Carbohydrate degeneration
D. Calcification
E. Protein degeneration
88. During cytoscopy mucous membrane
of urinary bladder normally makes folds
except for a single triangular area with
smooth mucosa. This triangle is located in
the following part of urinary bladder:
A. Bladder floor
B. Bladder cervix
C. Bladder apex
D. Bladder body
E. Bladder isthmus
89. A child suffers from drug idiosyncrasy.
What is the cause of such reaction?
A. Hereditary enzymopathy
B. Exhaustion of substrate interacting with
pharmaceutical substance
C. Accumulation of pharmaceutical
substance
D. Inhibition of microsomal liver enzymes
E. Associated disease of target organ
90. 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:
10
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
91. After a serious psychoemotional stress
a 48 year old patient suddenly developed
acute heart ache irradiating to the left
arm. Nitroglycerine relieved pain after 10
minutes. What is the leading pathogenetic
mechanism of this process development?
A. Spasm of coronary arteries
B. Dilatation of peripheral vessels
C. Obstruction of coronary vessels
D. Compression of coronary vessels
E. Increase in myocardial oxygen
consumption
92. A 42 year old patient complains
of pain in the epigastral area, vomiti-
ng; vomit masses have the colour of
"coffee-grounds", the patient has also
melena. Anamnesis records gastric ulcer.
Blood formula: erythrocytes - 2, 8 · 1012 /l,
leukocytes - 8 · 109 /l, Hb- 90 g/l. What
complication is it?
A. Haemorrhage
B. Penetration
C. Perforation
D. Canceration
E. Pyloric stenosis
93. A 56 year old patient suffering from
cardiac insufficiency has edema of feet
and shins, edematous skin is pale and cold.
What is the leding mechanism of edema
pathogenesis?
A. Rise of hydrostatic pressure in venules
B. Drop of oncotic pessure in capillaries
C. Increase of capillary permeability
D. Disorder of lymph outflow
E. Positive water balance
94. A disaster fighter at a nuclear power
plant developed hemorrhagic syndrome
on the background of acute radiation di-
sease. What is the most important factor
of syndrome pathogenesis?
A. Thrombocytopenia
B. Vascular wall damage
C. Increased activity of fibrinolysis factors
D. Increased activity of anticoagulative
system factors
E. Decreased activity of coagulative factors
95. To prevent postoperative bleeding a 6-
year-old child was administered vicasol
 Krok 1 Medicine 2012
that is a synthetic analogue of vitamin K.
Name post-translational changes of blood
coagulation factors that will be activated
by vicasol:
A. Carboxylation of glutamin acid
B. Phosphorylation of serine radicals
C. Partial proteolysis
D. Polymerization
E. Glycosylation
96. While under barbituric anaesthesia a
65 year old male patient developed respi-
ratory inhibition. Anesthesiologist made
him a 10 ml intravenous injection of 0,5%
bemegride solution. The patient’s condi-
tion got better, the pulmonary ventilati-
on volume increased. What phenomenon
underlies the interaction of these medi-
vcations?
A. Direct antagonism
B. Indirect antagonism
C. Unilateral antagonism
D. Direct synergism
E. Indirect synergism
97. A surgeon has to find the common
hepatic duct during the operative
intervention on account of concrements in
the gall ducts. The common hepatic duct
is located between the leaves of:
A. Hepatoduodenal ligament
B. Hepatogastric ligament
C. Hepatorenal ligament
D. Round ligament of liver
E. Venous ligament
98. Blood analysis of a patient wi-
th jaundice reveals conjugated bilirubi-
nemia, increased concentration of bile aci-
ds. There is no stercobilinogen in urine.
What type of jaundice is it?
A. Obstructive jaundice
B. Hepatocellular jaundice
C. Parenchymatous jaundice
D. Hemolytic jaundice
E. Cythemolytic jaundice
99. It is known that the gene responsible
for development of blood groups accordi-
ng to AB0 system has three allele vari-
ants. If a man has IV blood group, it can
be explained by the following variability
form:
A. Combinative
B. Mutational
C. Phenotypic
D. Genocopy
E. Phenocopy
11
100. Power inputs of a man were
measured. In what state was this man if
his power inputs were lower than basal
metabolism?
A. Sleep
B. Relaxation
C. Simple work
D. Nervous tension
E. Rest
101. A man is being measured power
inputs on an empty stomach, in the lying
position, under conditions of physical and
psychic rest at a comfortable temperature.
Power inputs will reach the maximum at:
A. 5-6 p.m.
B. 7-8 a.m.
C. 10-12 a.m.
D. 2-3 p.m.
E. 3-4 a.m.
102. When measuring power inputs of
a man by the method of indirect calori-
metry the following results were obtained:
1000 ml oxygen consumption and 800 ml
carbon dioxide liberation per minute. The
man under examination has the following
respiratory coefficient:
A. 0,8
B. 1,25
C. 0,9
D. 0,84
E. 1,0
103. A patient complains about impaired
evacuatory function of stomach (long-
term retention of food in stomach).
Examination revealed a tumour of initi-
al part of duodenum. Specify localization
of the tumour:
A. Pars superior
B. Pars inferior
C. Pars descendens
D. Pars ascendens
E. Flexura duodeni inferior
104. As a result of damage to certain
structures of brainstem an animal lost ori-
entation reflexes. What structures were
damaged?
A. Quadritubercular bodies
B. Medial nuclei of reticular formation
C. Red nuclei
D. Vestibular nuclei
E. Black substance
105. Emotional stress causes activation
of hormon-sensitive triglyceride lipase in
 Krok 1 Medicine 2012
the adipocytes. What secondary mediator
takes part in this process?
A. Cyclic adenosine monophosphate
B. Cyclic guanosine monophosphate
C. Adenosine monophosphate
D. Diacylglycerol
E. Ions of 2+
106. A patient has been diagnosed with
alkaptonuria. Choose an enzyme whose
deficiency can be the reason for this
pathology:
A. Homogentisic acid oxidase
B. Phenylalanine hydroxylase
C. Glutamate dehydrogenase
D. Pyruvate dehydrogenase
E. Dioxyphenylalanine decarboxylase
107. A 10 year old child had the mantoux
tuberculin test administered. 48 hours
later a papule up to 8 mm in diameter
appeared on the site of the injection.
What type of hypersensitivity reaction
developed after the tuberculin injection?
A. Type IV hypersensitivity reaction
B. Arthus phenomenon
C. Seroreaction
D. Atopic reaction
E. Type II hypersensitivity reaction
108. The patient with acute miocardi-
al infarction was given intravenously
different solutions during 8 hours
with medical dropper 1500 ml and
oxygen intranasally. He died because
of pulmonary edema. What caused the
pulmonary edema?
A. Volume overload of the left ventricular
B. Decreased oncotic pressure due to
hemodilution
C. Allergic reaction
D. Neurogenic reaction
E. Inhalation of the oxygen
109. In course of an operation surgeon
removed a part of a lung that was venti-
lated by a tertiary bronchus accompani-
ed by branches of pulmonary artery and
other vessels. What part of a lung was
removed?
A. Bronchopulmonary segment
B. Middle lobe
C. Inferior lobe
D. Superior lobe
E. Pulmonary lobule
110. After the second abortion a 23 year
old woman has been diagnosed with
12
toxoplasmosis. Which drug should be used
for toxoplasmosis treatment?
A. Co-trimoxazole
B. Itraconazole
C. Mebendazole
D. Azidothimidine
E. Acyclovir
111. Autopsy of a 17 year old girl who
died from pulmonary failure revealed
a small area of caseous necrosis in the
inferior lobe of the right lung, and
occurences of caseous necrosis in the
bronchopulmonary, bronchial and bi-
furcational lymph nodes. What is the most
probable postmortem diagnosis?
A. Primary tuberculosis
B. Hematogenous progression of primary
tuberculosis
C. Hematogenous tuberculosis with
predominant lung affection
D. Tuberculoma
E. Caseous pneumonia under secondary
tuberculosis
112. After 4 months of treatment for
tuberculosis the patient began complaini-
ng of toes and fingers numbness, sensati-
on of creeps. He was diagnosed with
polyneuritis. What antituberculous drug
might have caused these complications?
A. Isoniazid
B. Rifampicin
C. Ciprofloxacin
D. Sodium salt of benzylpenicillin
E. Alcohol iodine solution
113. Examination of a 55 year old woman
revealed under the skin of submandi-
bular area a movable slowly growing pasty
formation with distinct borders 1,0x0,7 cm
large. Histological examination revealed
lipocytes that form segments of diffrent
forms and sizes separated from each other
by thin layers of connective tissue with
vessels. What is the most probable di-
agnosis?
A. Lipoma
B. Fibroma
C. Angioma
D. Liposarcoma
E. Fibrosarcoma
114. According to the phenotypic di-
agnosis a female patient has been provi-
sionally diagnosed with X-chromosome
polysomia. This diagnosis can be confi-
rmed by a cytogenetic method. What
karyotype will allow to confirm the di-
 Krok 1 Medicine 2012 13

agnosis?
A. 47(ХХХ)
B. 48(XXXY)
C. 48(XXYY)
D. 47(XXY)
E. 46(XX)
115. A patient has been diagnosed with
acute glomerulonephritis that developed
after he had had streptococcal infecti-
on. It is most likely that the affection of
basal glomerular membrane is caused by
an allergic reaction of the following type:
A. Sodium valproate
B. Ethosuxemide
C. Amitriptyline
D. Phenytoin
E. Phenobarbital
120. A patient diagnosed with morphini-
sm has been admitted to the narcological
department. A doctor noted a decrease
in pharmacological activity of morphi-
ne. Repetitive use of a drug may result
in tolerance to its effect, and this
phenomenon is called:

A. Immune complex A. Addiction

B. Anaphylactic B. Cumulation
C. Cytotoxic C. Tachyphylaxis
D. Delayed D. Antagonism
E. Stimulating E. Allergy

116. An elderly patient has chronic 121. As a result of durative antibiotic

constipations induced by large intestine
hypotonia. What drug should be admini-
stered?
A. Bisacodyl
B. Sodium sulphate
C. Castor oil
D. Atropine
E. Novocaine amide
117. Examination of patients with peri-
odontitis revealed the interdependence
between the rate of affection of peri-
odontal tissues and the amount of
lysozymes in saliva and gingival liquid.
These results can be obtained during
studying the following protection system
of an organism:
A. Non-specific resistance
B. Humoral immunity
C. Cellular immunity
D. Autoresponsiveness
E. Tolerance
118. An isolated cell of human heart
automatically generates excitement
impulses with frequency of 60 times per
minute. This cell was taken from the
following heart structure:
A. Sinoatrial node
B. Atrium
C. Ventricle
D. Atrioventricular node
E. His’ bundle
119. A patient with epilepsy and depressi-
ve reaction has been administered a drug
that reduced epilepsy manifestations and
improved the patient’s psychic condition.
therapy a 37 year old patient developed
intestinal dysbacteriosis. What type of
drugs should be used in order to normali-
ze intestinal microflora?
A. Eubiotics
B. Sulfanilamides
C. Bacteriophages
D. Autovaccines
E. Vitamins
122. A man got poisoned with
mushrooms. They contain muscarine that
stimulates muscarinic cholinoreceptors.
What symptom is typical for poisoning
with inedible mushrooms?
A. Miosis
B. Mydriasis
C. Bronchi dilation
D. Heart rate rise
E. Arterial pressure rise
123. A patient complains of skin itch,
especially between fingers, in the inguinal
creases, on the lower abdomen. Exami-
nation of these regions revealed there
some small vesicles. Laboratory diagnosti-
cs allowed to establish that this condition
had been caused by a representative of
Arthropoda. Specify the disease caused
by this arthropod:
A. Scabies
B. Demodicosis
C. Myiasis
D. Pediculosis
E. Dermatotropic leishmaniasis
124. An infant has pylorospasm,
weakness, hypodynamia, convulsions as
 Krok 1 Medicine 2012
a result of frequent vomiting. What kind
of acid-base disbalance is it?
A. Excretory alkalosis
B. Excretory acidosis
C. Metabolic acidosis
D. Exogenous nongaseous acidosis
E. Gaseous alkalosis
125. During influenza epidemic 40% of
pupils who didn’t go in for sports were
affected by the disease, and among the
pupils who regularly did physical exercises
this index was only 20%. What adaptati-
ve mechanisms determined such a low si-
ckness rate of pupils participating in the
sports?
A. Cross adaptation
B. Specific adaptation
C. Physiological adaptation
D. Biochemical adaptation
E. Genetic adaptation
126. A 39 year old man who had been
operated for the stomach ulcer died 7 days
after the surgery. Autopsy revealed that
peritoneal leaves were dull, plephoric,
covered with massive yellow-greenish fi-
lms, the peritoneal cavity contained for
about 300 ml of thick yellow-greenish
liquid. What pathologic process was
revealed in the peritoneal cavity?
A. Fibrinous suppurative peritonitis
B. Serous peritonitis
C. Fibrinous serous peritonitis
D. Peritoneal commissures
E. Fibrinous haemorrhagic peritonitis
127. Preventive examination of a pati-
ent revealed an enlarged lymph node of
metastatic origin on the medial wall of the
left axillary crease. Specify the most likely
localization of the primary tumour:
A. Mammary gland
B. Submandibular salivary gland
C. Lung
D. Stomach
E. Thyroid gland
128. A 60 year old patient was found
to have a dysfunction of main digesti-
ve enzyme of saliva. This causes the di-
sturbance of primary hydrolysis of:
A. Carbohydrates
B. Fats
C. Proteins
D. Cellulose
E. Lactose
14
129. A patient suffers from stenocardia
and takes isosorbide mononitrate. He was
prescribed a complementary drug with di-
saggregating effect. What drug is it?
A. Acetylsalicinic acid
B. Nitroglycerine
C. Propranolol
D. Nifedipine
E. Validol
130. A 49 year old woman spent a lot of
time standing. As a result of it she got leg
edema. What is the most likely cause of
the edema?
A. Increase in hydrostatic pressure of
blood in veins
B. Decrease in hydrostatic pressure of
blood in veins
C. Decrease in hydrostatic pressure of
blood in arteries
D. Increase in oncotic pressure of blood
plasma
E. Increase in systemic arterial pressure
131. A patient presented to a hospital wi-
th complaints about quick fatigability and
significant muscle weakness. Examinati-
on revealed an autoimmune disease that
causes functional disorder of receptors
in the neuromuscular synapses. This wi-
ll result in the disturbed activity of the
following mediator:
A. Acetylcholine
B. Noradrenaline
C. Dopamine
D. Serotonin
E. Glycine
132. Blood test of a patient suffering
from atrophic gastritis gave the followi-
ng results: RBCs - 2, 0 · 1012 /l, Hb- 87 g/l,
colour index - 1,3, WBCs - 4, 0 · 109 /l,
thrombocytes - 180 · 109 /l. Anaemia mi-
gh have been caused by the following
substance deficiency:
A. Vitamin B12
B. Vitamin A
C. Vitamin K
D. Iron
E. Zinc
133. A 45 year old man consulted a doctor
about a plaque-like formation on his neck.
Histological examination of a skin bi-
optate revealed clusters of round and
oval tumour cells with a narrow border of
basophilic cytoplasm resembling of cells
of basal epidermal layer. What tumour is
it?
 Krok 1 Medicine 2012
A. Basal cell carcinoma
B. Epidermal cancer
C. Hydroadenoma
D. Trichoepithelioma
E. Syringoadenoma
134. A 71 year old man had been presenti-
ng with diarrhea for 10 days. The feces
had admixtures of blood and mucus. He
was delivered to a hospital in grave condi-
tion and died 2 days later. Autopsy of the
body revealed the following: diphtheri-
tic colitis with multiple irregularly-shaped
ulcers of different depth in both sigmoid
colon and rectus. Bacteriological analysis
revealed Shigella. What was the main di-
sease?
A. Dysentery
B. Typhoid fever
C. Salmonellosis
D. Nonspecific ulcerous colitis
E. Yersiniosis
135. In spite of treatment with cardiotoni-
cs and thiazide diuretic a patient suffering
from chronic cardiac failure still presents
with edemata and faces a risk of ascites.
What medication should be administered
in order to increase the diuretic effect of
the above mentioned drugs?
A. Spironolactone
B. Furosemide
C. Amiloride
D. Clopamide
E. Manithol
136. Autopsy of a 75 year old patient
who had been suffering from dissemi-
nated atherosclerosis and died under
chronic cardiac failure revealed constricti-
on and deformation of coronary arteries,
tuberous intima whose section appeared
to be white and petrosal. Specify the stage
of atherosclerosis morphogenesis:
A. Atherocalcinosis
B. Lipoidosis
C. Liposclerosis
D. Bilipid
E. Atheromatosis
137. Examination of a bronchial tissue
sample revealed atrophy of mucous
membrane, cystic degeneration of glands,
focal metaplastic changes of lining pri-
smatic epithelial cells into multilayer
squamous cells; increase in goblet cell
number; in some parts of bronchial wall
and especially in the mucous membrane
there was marked cellular inflammatory
15
infiltration and growth of granulation ti-
ssue bulging into the bronchial lumen in
form of a polyp. What is the most likely
diagnosis?
A. Chronic bronchitis
B. Lobar pneumonia
C. Acute bronchitis
D. Bronchopneumonia
E. Interstitial pneumonia
138. Acute renal impairment caused
death of a bleeding patient. Autopsy
revealed enlarged kidneys with a broad
pale pink cortical layer expressively
demarcated from dark red renal pyrami-
ds. Macroscopic examination revealed
lack of epithelial nuclei of convoluted
tubules, tubulorrhexis, phlebostasis. The
cell nuclei of choroid glomus and straight
tubules were present. What pathology is
it?
A. Necronephrosis
B. Infarction
C. Glomerulonephritis
D. Pyelonephritis
E. Nephrosis
139. Osteolaterism 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 the followi-
ng enzyme:
A. Lysyl oxidase
B. Monoamino-oxidase
C. Prolyl hydroxylase
D. Lysyl hydroxylase
E. Collagenase
140. A histological specimen of ki-
dney shows a structure consisting of a
glomerulus of fenestrated capillaries and
a bilayer epithelial capsule. Specify this
structure:
A. Renal corpuscle
B. Proximal tubule
C. Distal tubule
D. Henle’s loop
E. Receiving tube
141. A 66 year old female patient
got intravenous injection of magnesi-
um sulfate solution for the purpose of
elimination of hypertensive crisis. But
arterial pressure didn’t go down and
after repeated introduction of the same
preparation there appered sluggishness,
slow response, inhibition of consciousness
and respiration. What preparation is
 Krok 1 Medicine 2012 16

antagonist of magnesium sulfate and can A. Mosaicism

eliminate symptoms of its overdose? B. Inversion
C. Transposition
A. Calcium chloride D. Duplication
B. Potassium chloride E. Heterogeneity
C. Sodium chloride
D. Activated carbon 146. An oncological patient had been
E. Potassium permanganate administered methotrexate. With time
target cells of the tumour lost sensitivity to
142. As a result of a road accident a 26- this drug. At the same time the change in
year-old man is in the torpid phase of gene expression of the following enzyme
shock. Blood count: leukocytes - 3, 2 · is observed:
109 /l. What is the leading mechanism of
leukopenia development? A. Dehydropholate reductase
B. Thiaminase
A. Leukocyte redistribution in the C. Deaminase
bloodstream D. Pholate oxidase
B. Leukopoiesis inhibition E. Pholate decarboxylase
C. Faulty release of mature leukocytes
from the bone marrow into the blood 147. A 64 year old woman has impairment
D. Leukocyte destruction in the hematopi- of twilight vision (hemeralopy). What vi-
etic organs tamin should be recommended in the first
E. Increased excretion of the leukocytes place?
from the organism
A. A
143. A 5-month-old boy was hospitali- B. B2
zed for tonic convulsions. He has a life- C. E
time history of this disease. Examination D. C
revealed coarse hair, thinned and fragile E. B6
nails, pale and dry skin. In blood: calci-
um - 1,5 millimole/l, phosphor - 1,9 milli- 148. A patient underwent appendectomy.
mole/l. These changes are associated with: In the postoperative period he has been
taking an antibiotic. The patient complai-
A. Hypoparathyroidism ns about hearing impairment and vesti-
B. Hyperparathyroidism bular disorders. What group of antibiotics
C. Hyperaldosteronism has such by-effects?
D. Hypoaldosteronism
E. Hypothyroidism A. Aminoglycosides
B. Penicillins
144. As a result of a trauma a patient has C. Tetracyclines
developed traumatic shock that led to the D. Macrolides
following disorders: AP is 140/90 mm Hg, E. Cephalosporins
Ps is 120 bpm. The patient is fussy, talkati-
ve, pale. Such state relates to the following 149. While playing a child got a punch
shock phase: in the presternum region. As a result
of this trauma an organ located behind
A. Erectile the presternum was damaged. Name this
B. Latent period organ:
C. Terminal
D. Torpid A. Thymus
E. - B. Thyroid gland
C. Heart
145. Cytogenetic examination of a pati- D. Pericardium
ent with dysfunction of the reproductive E. Larynx
system revealed normal karyotype 46,ХУ
in some cells, but most cells have Kli- 150. In an embryo the process of dorsal
nefelter’s syndrome karyotype - 47,ХХУ. mesoderm segmentation and somite
Such phenomenon of cell inhomogeneity formation is disturbed. What part of
is called: skin will probably have developmental
abnormalities?
 Krok 1 Medicine 2012
A. Dermis
B. Hair
C. Sebaceous glands
D. Epidermis
E. Perspiratory glands
151. A patient consulted a dentist about
itching and burning in the oral cavity; high
temperature. The patient was diagnosed
with trichomonal gingivostomatitis. What
drug should be chosen for his treatment?
A. Metronidazole
B. Ampicillin
C. Doxycycline hydrochloride
D. Gentamicin sulfate
E. Nystatin
152. An electron microphotography of a
fragment of proper gastric gland shows
a big irregular round-shaped cell. There
are a lot of intracellular tubules and mi-
tochondria in the cytoplasm. Specify this
cell:
A. Parietal cell
B. Principal cell
C. Undifferentiated cell
D. Mucous cell
E. Endocrine cell
153. A patient suffering from stenocardia
was taking nitroglycerine which caused
restoration of blood supply of myocardi-
um and relieved pain in the cardiac area.
What intracellular mechanism provides
restoration of energy supply of insulted
cells?
A. Intensification of ATP resynthesis
B. Reduction of ATP resynthesis
C. Increased permeability of membranes
D. Intensification of oxygen transporting
into the cell
E. Intensification of RNA generation
154. A 50 year old patient has been taki-
ng 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
tumour-like formations, cysts. Bony tissue
was substituted by fibrous connective ti-
ssue. Examination revealed also adenoma
of parathyroid gland and hypercalcemia.
What is the most probable diagnosis?
17
A. Parathyroid osteodystrophy
B. Myelomatosis
C. Osteomyelitis
D. Osteopetrosis
E. Paget’s disease
155. A patient has been diagnosed wi-
th a compression fracture of a lumbar
vertebra. As a result he has a consi-
derable increase in curvature of the
lumbar lordosis. Which ligament damage
can induce such changes in the spine
curvature?
A. Anterior longitudinal ligament
B. Posterior longitudinal ligament
C. Yellow ligament
D. Iliolumbar ligament
E. Interspinous ligament
156. When water affects mucous
membrane of the inferior nasal meatuses,
this causes "diver reflex"that provokes:
A. Reflectory apnea
B. Reflectrory dyspnea
C. Reflectory hyperpnea
D. Cough
E. Bronchospasm
157. Life cycle of a cell includes a
process of DNA autoreduplication. As
a result of this process monochromatid
chromosomes become bichromatid. This
phenomenon is observed within the
following period of the cell cycle:
A. S
B. G0
C. G1
D. G2
E. M
158. Examination of a child who
frequently suffers from infectious diseases
revealed that IgG concentration in blood
serum was 10 times less than normal, IgA
and IgM concentration was also signifi-
cantly reduced. Analysis showed also lack
of B-lymphocytes and plasmocytes. What
disease are these symptoms typical for?
A. Bruton’s disease
B. Swiss-type agammaglobulinemia
C. Dysimmunoglobulinemia
D. Louis-Bar syndrome
E. Di George syndrome
159. Examination of a 42 year old patient
revealed a tumour of adenohypophysis.
Objectively: the patient’s weight is 117
kg, he has moon-like hyperemic face, red-
blue striae of skin distension on his belly.
 Krok 1 Medicine 2012 18

Osteoporosis and muscle dystrophy are
present. AP is 210/140 mm Hg. What is
the most probable diagnosis?
A. Cushing’s disease
B. Cushing’s syndrome
C. Conn’s disease
D. Diabetes mellitus
E. Essential hypertension
160. Microelectrode technique allowed
to register a potential following
"all-or-none"law and being able of
undecremental spreading. Specify this
potential:
A. Action potential
B. Excitatory postsynaptic potential
C. Rest potential
D. Inhibitory postsynaptic potential
E. Receptor potential
161. A patient has been diagnosed with
transmural myocardial infarction. What
drug should be given in order to prevent
cardiogenic shock?
A. Promedol
B. Reserpin
C. Octadine
D. Phentolamine
E. Analgin
162. 2 days after labour a woman
developed shock along with DIC
syndrome that caused her death. Autopsy
revealed purulent endomyometritis, regi-
onal purulent lymphangitis, lymphadeni-
tis and purulent thrombophlebitis. There
were also dystrophic alterations and
interstitial inflammation of parenchymal
organs. What is the most likely diagnosis?
A. Septicemia
B. Syphilis
C. Tuberculosis of genital organs
D. Chorioadenoma destruens
E. Hydatid mole
163. A patient got an injury of spinal
marrow in a road accident that caused
loss of tactile sensation, posture sense, vi-
bration sense. What conduction tracts are
damaged?
A. Fascicle of Goll and cuneate fascicle
B. Anterior spinocerebellar tract
C. Rubrospinal tract
D. Reticulospinal tract
E. Tectospinal tract
164. Examination of a patient revealed
II grade obesity. It is known that he
consumes a lot of sweets and rich food,
has sedentary way of life. That’s why
anabolic metabolism has the priority in
his organism. Which of the following
pathways is amphibolic?
A. Cycle of tricarboxylic acids
B. Glyconeogenesis
C. Lipolysis
D. Glycolysis
E. Fatty acids oxidation
165. A patient who abuses smoking has
chronic bronchitis. Biopsy of his primary
bronchus revealed multilayer pavement
epithelium. What pathological process
was revealed in the bronchus?
A. Metaplasia
B. Physiological regeneration
C. Reparative regeneration
D. Hyperplasia
E. Dysplasia
166. A patient suffers from pulmonary
tuberculosis. During treatment neuritis of
visual nerve arose. What drug has caused
this by-effect?
A. Isoniazid
B. Ethambutol
C. Kanamycin
D. Rifampicin
E. Streptomycin
167. A 67 year old patient complains of
periodic heart ache, dyspnea during light
physical activities. ECG reveals extraordi-
nary contractions of heart ventricles. Such
arrhythmia is called:
A. Extrasystole
B. Bradycardia
C. Tachycardia
D. Flutter
E. Fibrillation
168. A patient with ischemic heart disease
has been administered an anti-anginal
drug that reduces the myocardial oxygen
consumption and improves blood supply
of myocardium. What drug is it?
A. Nitroglycerine
B. Validol
C. Propranolol
D. Promedol
E. Retabolil
169. A doctor asked a patient to breath
out fully after taking a normal breath.
What muscles contract during such
exhalation?
 Krok 1 Medicine 2012
A. Abdominal muscles
B. External intercostal muscles
C. Diaphragm
D. Trapezius muscles
E. Pectoral muscles
170. 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?
A. Impaired synthesis of calcitriol
B. Increased excretion of calcium
C. Hyperfunction of parathyroid glands
D. Hypofunction of parathyroid glands
E. Lack of calcium in food
171. A man was intoxicated with
mushrooms. They contain muscarine that
stimulates muscarinic cholinoreceptors.
What symptoms signalize intoxication wi-
th inedible mushrooms?
A. Myotic pupils
B. Mydriatic pupils
C. Bronchi dilatation
D. Increased heart rate
E. Rise of arterial pressure
172. There was a record of some anthrax
cases among animals in a countryside.
The spread of disease can be prevented
by means of immunization. What kind of
vaccine should be used?
A. STI live vaccine
B. BCG vaccine
C. Salk vaccine
D. Sabin’s vaccine
E. Diphteria and tetanus toxoids and
pertussis vaccine
173. An infectious disease unit admitted a
patient with signs of jaundice caused by
hepatitis virus. Select an indicator that is
specific only for parenchymatous jaundi-
ce:
A. Increase in ALT and AST rate
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholaemia
E. Urobilinuria
174. A patient presents with dysfuncti-
on of cerebral cortex accompanied by
epileptic seizures. He has been admini-
stered a biogenic amine synthetized from
glutamate and responsible for central
inhibition. What substance is it?
19
A. Gamma-amino butyric acid
B. Serotonin
C. Dopamine
D. Acetylcholine
E. Histamine
175. A 50 year old patient underwent
resection of tumour of large intestine
wall. Microscopically it presents itself as
fascicles of divergent collagen fibers of
different thickness and form and some
monomorphous fusiform cells that are
irregularly distributed among the fibers.
Cellular atypia is not evident. What
tumour is it?
A. Hard fibroma
B. Fibromyoma
C. Soft fibroma
D. Desmoma
E. Fibrosarcoma
176. Toxic affection of liver results in
dysfunction of protein synthesis. It is
usually accompanied by the following ki-
nd of dysproteinemia:
A. Absolute hypoproteinemia
B. Relative hypoproteinemia
C. Absolute hyperproteinemia
D. Relative hyperproteinemia
E. Paraproteinemia
177. A cell at the stage of mitosis anaphase
was stimulated by colchicine that inhibi-
ts chromosome separation to the poles.
What type of mutation will be caused?
A. Polyploidy
B. Inversion
C. Deletion
D. Duplication
E. Translocation
178. Examination of duodenal contents
revealed some pyriform protozoa with
twin nuclei and four pairs of flagella.
There were two supporting filaments
between the nuclei and a suctorial disc
on the ventral side. What representative
of protozoa was revealed in this patient?
A. Lamblia
B. Toxoplasma
C. Leishmania
D. Intestinal trichomonad
E. Trypanosome
179. In order to prevent massive
haemorrhage in the region of oral cavi-
ty floor it is required to ligate an artery
which is located within Pirogov’s triangle.
What artery is it?
 Krok 1 Medicine 2012
A. Lingual artery
B. Superior thyroid artery
C. Facial artery
D. Ascending pharyngeal artery
E. Maxillary artery
180. A patient with high-titer antinuclear
antibodies died from progressing renal
impairment. Autopsy revealed mesangi-
oproliferative glomerulonephritis and
abacterial polypous endocarditis. There
was periarterial bulbar sclerosis in spleen
and productive proliferative vasculitis in
skin. What is the most likely diagnosis?
A. Systemic lupus erythematosus
B. Nephrotic syndrome
C. Rheumatism
D. Dermatomyositis
E. Periarteritis nodosa
181. A shepherd who has tended
sheep together with dogs consulted a
doctor about pain in his right subcostal
area, nausea, vomiting. Roentgenoscopy
revealed a tumour-like formation. What
kind of helminthiasis might be suspected?
A. Echinococcosis
B. Ascaridiasis
C. Enterobiasis
D. Taeniarhynchosis
E. Taeniasis
182. For relief of hypertensive crisis a
doctor administered a patient a drug
that apart from antihypertensive effect
has also sedative, spasmolytic and anti-
convulsive effect. The drug was taken
parenterally. When it is taken enterally
it acts as a laxative and cholagogue. What
drug was administered?
A. Magnesium sulfate
B. Dibasolum
C. Reserpine
D. No-spa
E. Apressin
183. A bacteriological laboratory received
sputum sample of a patient suffering from
tuberculosis. Bacterioscopic examination
of smears and detection of tuberculosis
bacillus can be realized by one of enri-
chment methods that involves processing
of sputum only with solution of caustic
soda. What is this method called?
20
A. Homogenization
B. Inactivation
C. Flotation
D. Filtration
E. Neutralization
184. Electronic microphotography of
pulmonary alveole’s wall presents a big
cell. Its cytoplasm has a lot of mi-
tochondria, developed Golgi apparatus,
osmiophil lamellated corpuscles. What is
the main function of this cell?
A. It produces surfactant
B. It is a component of blood-air barrier
C. It warms the air
D. It purifies the air
E. It absorbs microorganisms
185. A patient with diabetes mellitus
complicated by angiopathy has been
recommended a drug which is a sulphonyl
urease derivate of the second generati-
on. It improves microcirculation and is
known for its relatively good tolerance.
What drug is it?
A. Glibenclamide
B. Glibutidum
C. Insulin
D. Acarbose
E. Adrenalin
186. A child is pale, pastose, muscular ti-
ssue is bad developed, lymph nodes are
enlarged. He often suffers from angi-
na and pharyngitis, blood has signs of
lymphocytosis. The child is also predi-
sposed to autoallergic diseases. What type
of diathesis can be presumed in this case?
A. Lymphohypoplastic
B. Exudative
C. Gouty
D. Asthenic
E. Hemorrhagic
187. A 26 year old pregnant woman is
under treatment at an in-patient hospi-
tal. After a continuous attack of vomiting
she was found to have reduced volume of
circulating blood. What kind of change in
general blood volume is the case?
A. Polycythemic hypovolemia
B. Simple hypovolemia
C. Oligocythemic hypovolemia
D. Polycythemic hypervolemia
E. Oligocythemic hypervolemia
188. Vomiting matters of a patient
suspected of having cholera were deli-
vered to the bacteriological laboratory.
 Krok 1 Medicine 2012
The material was used for preparing a
"hanging drop"specimen. What type of
microscopy will be applied for identificati-
on of the causative agent by its mobility?
A. Phase-contrast microscopy
B. Electron microscopy
C. Immune and electron microscopy
D. Fluorescence microscopy
E. Immersion microscopy
189. Examination of a 6-month-old child
revealed a delay in closure of the occipi-
tal fontanelle. When should it normally
close?
A. Until 3 months
B. Before the child is born
C. Until 6 months
D. Until the end of the first year of life
E. Until the end of the second year of life
190. A 45 year old male died from di-
sseminated tuberculosis. On autopsy the
symptoms of tuberculosis were confirmed
by both microscopical and histological
analyses. All the affected organs had
epithelioid cell granulomas with caseous
necrosis in the centre. What kind of
hypersensitivity reaction underlies the
process of granuloma development?
A. Delayed
B. Antibody-dependent cytotoxicity
C. Complement-dependent cytotoxicity
D. Anaphylactic
E. Immune complex
191. A male patient has been diagnosed
with acute radiation disease. Laboratory
examination revealed a considerable
reduction of platelet serotonin level. The
likely cause of platelet serotonin reducti-
on is the disturbed metabolism of the
following substance:
A. 5-oxytryptofane
B. Tyrosine
C. Histidine
D. Phenylalanine
E. Serine
192. In course of a conditional experiment
the development of mesenchyma cells
was completely inhibited. Development
of the following muscular tissue will be di-
sturbed:
A. Smooth muscular tissue
B. Neural muscular tissue
C. Epidermal muscular tissue
D. Cardiac muscular tissue
E. Skeletal muscular tissue
21
193. Sex chromosomes of a woman didn’t
separate and move to the opposite poles
of a cell during gametogenesis (meiosis).
The ovum was impregnated with a normal
spermatozoon. Which chromosomal di-
sease can be found in her child?
A. Turner’s syndrome
B. Down’s syndrome
C. Patau’s syndrome
D. Edwards’ syndrome
E. Cat cry syndrome
194. After taking poor-quality food a pati-
ent developed repeated episodes of di-
arrhea. On the next day he presented with
decreased arterial pressure, tachycardia,
extrasystole. Blood pH is 7,18. These
abnormalities were caused by the
development of:
A. Nongaseous acidosis
B. Gaseous acidosis
C. Nongaseous alkalosis
D. Gaseous alkalosis
E. Metabolic alkalosis
195. A patient has been diagnosed with
influenza. His condition became drasti-
cally worse after taking antipyretic drugs.
His consciousness is confused, AP is 80/50
mm Hg, Ps is 140/m, body temperature
droped down to 35, 8oC. What complicati-
on developed in this patient?
A. Collapse
B. Hyperthermia
C. Hypovolemia
D. Acidosis
E. Alkalosis
196. One of sections of central nervous
system has layerwise arrangement of
neurocytes. Among them there are cells
of the following forms: stellate, fusiform,
horizontal, pyramidal. What section of
central nervous system is this structure
typical for?
A. Cortex of cerebrum
B. Spinal cord
C. Cerebellum
D. Medulla oblongata
E. Hypothalamus
197. Pharmacological effects of anti-
depressants are based upon blocking
(inhibiting) the enzyme that acts as a
catalyst for the breakdown of biogenic
amines noradrenalin and serotonin in the
mitochondria of cephalic neurons. What
enzyme takes part in this process?
 Krok 1 Medicine 2012 22

A. Monoamine oxidase In order to determine the diphtheria

B. Transaminase causative agent the material should be
C. Decarboxylase inoculated into the following differenti-
D. Peptidase al diagnostic medium:
E. Lyase
A. Blood tellurite agar
198. During examination of a pati- B. Endo’s agar
ent a dentist revealed a lot of "white C. Ploskyrev’s agar
spots zones of enamel demineralization. D. Sabouraud’s agar
What microorganisms take part in the E. Levenshtein-Yessen agar
development of this process?
200. A man with a stab wound in the regi-
A. Streptococcus mutans on of the quadrilateral foramen consulted
B. Streptococcus salivarius a doctor about it. Examination revealed
C. Streptococcus pyogenes that the injured couldn’t abduct his arm
D. Veilonella parvula from the body. What nerve is most likely
E. Staphylococcus epidermidis damaged?
199. A 4 year old child presents with A. n. axillaris
general weakness, sore throat and degluti- B. n. medianus
tive problem. After his examination a C. n. radialis
doctor suspected diphtheria and sent the D. n. ulnaris
material to the bacteriological laboratory. E. n. subclavius
 Krok 1 Medicine 2013
1. A patient diagnosed with focal
tuberculosis of the upper lobe of the right
lung had been taking isoniazid as a part
of combination therapy. After some time,
the patient reported of muscle weakness,
decreased skin sensitivity, blurred visi-
on, impaired motor coordination. Whi-
ch vitamin preparation should be used to
address these phenomena?
A. Vitamin B6
B. Vitamin A
C. Vitamin D
D. Vitamin B12
E. Vitamin C
2. A 60-year-old male patient has a 9-year
history of diabetes and takes insulin Semi-
lente for the correction of hyperglycemia.
10 days ago he began taking anaprilin
for hypertension. One hour after admini-
stration of the antihypertensive drug the
patient developed hypoglycemic coma.
What is the mechanism of hypoglycemia
in case of anaprilin use?
A. Inhibition of glycogenolysis
B. Reduction of glucagon half-life
C. Increase of insulin Semilente half-life
D. Increase of bioavailability of insulin
Semilente
E. Decrease in glucose absorption
3. Pterin derivatives (aminopterin and
methotrexate) are the inhibitors of di-
hydrofolate reductase, so that they inhibit
the regeneration of tetrahydrofolic acid
from dihydrofolate. These drugs inhibit
the intermolecular tranfer of monocarbon
groups, thus suppressing the synthesis of
the following polymer:
A. DNA
B. Protein
C. Homopolysaccharides
D. Gangliosides
E. Glycosaminoglycans
4. A child with suspected tuberculosis was
given Mantoux test. After 24 hours the
site of the allergen injection got swollen,
hyperemic and painful. What are the main
components that determine such response
of the body?
1
A. Mononuclear cells, T-lymphocytes and
lymphokines
B. Granulocytes, T-lymphocytes and IgG
C. Plasma cells, T-lymphocytes and
lymphokines
D. B-lymphocytes, IgM
E. Macrophages, B-lymphocytes and
monocytes
5. Hemoglobin catabolism results in
release of iron which is transported to
the bone marrow by a certain transfer
protein and used again for the synthesis of
hemoglobin. Specify this transfer protein:
A. Transferrin (siderophilin)
B. Transcobalamin
C. Haptoglobin
D. Ceruloplasmin
E. Albumin
6. A 12-year-old boy has been hospitali-
zed for suspected food poisoning. The
fecal samples were inoculated on the
Endo agar, which resulted in growth of
a large number of colorless colonies.
What microorganism is most likely to be
EXCLUDED from the list of possible
causative agents of the disease?
A. Escherichia coli
B. Salmonella enteritidis
C. Proteus vulgaris
D. Pseudomonas aeruginosa
E. Yersinia enterocolitica
7. A 23-year-old patient has been admi-
tted to a hospital with a craniocerebral
injury. The patient is in a grave condition.
Respiration is characterized by prolonged
convulsive inspiration followed by a short
expiration. What kind of respiration is it
typical for?
A. Apneustic
B. Gasping breath
C. Kussmaul’s
D. Cheyne-Stokes
E. Biot’s
8. It has been experimentally proven that
the excitation of the motor neurons of
flexor muscles is accompanied by the inhi-
bition of the motor neurons of extensor
muscles. What type of inhibition underli-
es this phenomenon?
A. Reciprocal
B. Inhibition after excitation
C. Pessimal
D. Feedback
E. Lateral
 Krok 1 Medicine 2013
9. A 3-year-old boy with pronounced
hemorrhagic syndrome doesn’t have anti-
hemophilic globulin A (factor VIII) in
the blood plasma. Hemostasis has been
impaired at the following stage:
A. Internal mechanism of prothrombinase
activation
B. External mechanism of prothrombinase
activation
C. Conversion of prothrombin to thrombin
D. Conversion of fibrinogen to fibrin
E. Blood clot retraction
10. A patient got a gunshot wound of
hip which damaged the sciatic nerve. Any
impact on the affected limb causes severe,
excruciating pain. What mechanism of
pain is most likely in this case?
A. Causalgic
B. Reflex
C. Phantom
D. Endorphin hypofunction
E. Enkephalin hypofunction
11. A 60-year-old patient with a long hi-
story of stenocardia takes coronarodilator
agents. He has also been administered
acetylsalicylic acid to reduce platelet
aggregation. What is the mechanism of
antiplatelet action of acetylsalicylic acid?
A. It reduces the activity of cyclooxygenase
B. It reduces the activity of phosphodi-
esterase
C. It enhances the activity of platelet
adenylate cyclase
D. It enhances the synthesis of prostacyclin
E. It has membrane stabilizing effect
12. A patient with bronchial asthma has
developed acute respiratory failure. What
kind of respiratory failure occurs in this
case?
A. Obstructive disturbance of alveolar
ventilation
B. Restrictive ventilatory defect
C. Perfusion
D. Diffusion
E. Dysregulation of alveolar ventilation
13. On the fifth day after the acute
blood loss a patient has been diagnosed
with hypochromic anemia. What is
the main mechanism of hypochromia
development?
2
A. Release of immature red blood cells
from the bone marrow
B. Impaired iron absorption in the intesti-
nes
C. Increased destruction of red blood cells
in the spleen
D. Impaired globin synthesis
E. Increased excretion of body iron
14. A patient with diabetes developed
a diabetic coma due to the acid-base
imbalance. Specify the kind of this
imbalance:
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Gaseous alkalosis
E. Non-gaseous alkalosis
15. A girl receives antibiotics of the penici-
llin group for acute bronchitis. On the thi-
rd day of treatment she developed allergic
dermatitis. Which drug should be admini-
stered?
A. Loratadine
B. Cromolyn sodium
C. Beclomethasone
D. Ephedrine hydrochloride
E. Levamisole
16. A female patient has been di-
agnosed with cervical erosion, which is
a precancerous pathology. What defense
mechanism can prevent the development
of a tumor?
A. Increase in natural killer level (NK-
cells)
B. High-dose immunological tolerance
C. Increase in the activity of lysosomal
enzymes
D. Simplification of the antigenic structure
of tissues
E. Low-dose immunological tolerance
17. Microscopy of the coronary artery of
a dead 53-year-old patient revealed lumi-
nal occlusion due to a fibrous plaque wi-
th some lipids. The most likely form of
atherosclerosis in this case is:
A. Liposclerosis
B. Lipidosis
C. Prelipid stage
D. Atheromatosis
E. Ulceration
18. Autopsy of the patient revealed bone
marrow hyperplasia of tubular and flat
bones (pyoid marrow), splenomegaly
(6 kg) and hepatomegaly (5 kg),
 Krok 1 Medicine 2013
enlargement of all lymph node groups.
What disease are the identified changes
typical for?
A. Chronic myelogenous leukemia
B. Chronic lymphocytic leukemia
C. Multiple myeloma
D. Polycythemia vera
E. Hodgkin’s disease
19. As a result of an injury a patient
cannot extend his arm at the elbow. This
may cause abnormal functioning of the
following muscle:
A. Musculus triceps brachii
B. Musculus infraspinatus
C. Musculus levator scapulae
D. Musculus teres major
E. Musculus subscapularis
20. A man sitting with his eyes closed,
undergoes electroencephalography. What
rhythm will be recorded on the EEG if
there is an audible signal?
A. Beta rhythm
B. Theta rhythm
C. Delta rhythm
D. Alpha rhythm
E. Gamma rhythm
21. Electrophoretic study of a blood
serum sample, taken from the patient with
pneumonia, revealed an increase in one of
the protein fractions. Specify this fraction:
A. γ-globulins
B. Albumins
C. α1 -globulins
D. α2 -globulins
E. β-globulins
22. Examination of an 18-year-old gi-
rl revealed the following features:
hypoplasia of the ovaries, broad
shoulders, narrow pelvis, shortening of the
lower extremities, "sphinx neck". Mental
development is normal. The girl was di-
agnosed with Turner’s syndrome. What
kind of chromosome abnormality is it?
A. Monosomy X
B. Trisomy X
C. Trisomy 13
D. Trisomy 18
E. Nullisomy X
23. Hypertrichosis is the Y-linked
character. The father has hypertrichosis,
and the mother is healthy. In this fami-
ly, the probability of having a child with
hypertrichosis is:
3
A. 0,5
B. 0,25
C. 0,125
D. 0,625
E. 1
24. A casualty has a fracture in the region
of the inner surface of the left ankle. What
is the most likely site for the fracture?
A. Medial malleolus
B. Lower third of the fibula
C. Astragalus
D. Lateral malleolus
E. Calcaneus
25. Some infectious diseases caused by
bacteria are treated with sulfanilamides
which block the synthesis of bacteria
growth factor. What is the mechanism of
their action?
A. They are antivitamins of para-amino
benzoic acid
B. They inhibit the absorption of folic acid
C. They are allosteric enzyme inhibitors
D. They are involved in redox processes
E. They are allosteric enzymes
26. A 42-year-old male patient with
gout has an increased blood uric acid
concentration. In order to reduce the level
of uric acid the doctor administered him
allopurinol. Allopurinol is the competiti-
ve inhibitor of the following enzyme:
A. Xanthine oxidase
B. Adenosine deaminase
C. Adenine phosphoribosyltransferase
D. Hypoxanthine-
phosphoribosyltransferase
E. Guanine deaminase
27. A 40-year-old female patient di-
agnosed with acute pancreatitis has been
delivered to the admission department of
a regional hospital. What drug should be
administered the patient in the first place?
A. Contrycal
B. Platyphyllin
C. Atropine
D. Metacin
E. Pirenzepine
28. A patient consulted a doctor about
being unable to abduct his right arm after
a past trauma. Examination revealed that
the passive movements were not limi-
ted. The patient was found to have the
atrophy of the deltoid muscle. What nerve
is damaged?
 Krok 1 Medicine 2013
A. Axillary
B. Radial
C. Ulnar
D. Median
E. Suprascapular
29. After a trauma of the upper third of
the anterior forearm a patient exhibits
difficult pronation, weakening of palmar
flexor muscles and impaired skin sensiti-
vity of 1-3 fingers. Which nerve has been
damaged?
A. n. medianus
B. n. musculocutaneus
C. n. ulnaris
D. n. cutaneus antebrachii medialis
E. n. radialis
30. A 38-year-old female patient complai-
ns 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 obesi-
ty most typical for?
A. Cushing pituitary basophilism
B. Alimentary obesity
C. Myxedema
D. Insulinoma
E. Babinski-Frohlich syndrome
31. A 60-year-old patient with a long
history of atherosclerosis and a previ-
ous myocardial infarction developed an
attack of retrosternal pain. 3 days later
the patient was hospitalized and then di-
ed of progressive cardiovascular insuffici-
ency. At autopsy a white fibrous depressed
area about 3 cm in diameter with clear
boundaries was found in the posterior
wall of the left ventricle and interventri-
cular septum. The dissector evaluated
these changes as:
A. Focal cardiosclerosis
B. Myocardial ischemia
C. Myocardial infarction
D. Myocarditis
E. Myocardial degeneration
32. Measurements of the arterial pCO2
and pO2 during an attack of bronchi-
al asthma revealed hypercapnia and
hypoxemia respectively. What kind of
hypoxia occurred in this case?
4
A. Respiratory
B. Hemic
C. Circulatory
D. Tissue
E. Histotoxic
33. A female patient with bronchial
asthma had taken prednisolone tablets (1
tablet 3 times a day) for 2 months. Due to
a significant improvement of her conditi-
on the patient suddenly stopped taking it.
What complication is likely to develop in
this case?
A. Withdrawal syndrome
B. Cushing’s syndrome
C. Gastrorrhagia
D. Upper body obesity
E. Hypotension
34. A patient with suspected dysentery
has been admitted to the infectious di-
seases hospital. Which basic method of
laboratory diagnosis must be applied in
the first place?
A. Bacteriological
B. Serological
C. Allergic
D. Biological
E. Microscopic
35. During a surgery with the use of
hygronium the patient had an abrupt fall
in blood pressure. Blood pressure can be
normalized by the representatives of the
following drug group:
A. α-adrenergic agonists
B. α-blockers
C. Ganglionic blockers
D. M-cholinergic agents
E. N-cholinergic agents
36. 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?
A. Compensated respiratory acidosis
B. Compensated metabolic acidosis
C. Decompensated metabolic acidosis
D. Compensated respiratory alkalosis
E. Decompensated respiratory alkalosis
37. On examination a patient was found
to have medial strabismus, the inward
deviation of the eyeball and inability to
abduct the eyeball outwards. What nerve
is damaged?
 Krok 1 Medicine 2013
A. Abducent
B. Oculomotor
C. Ocular
D. Trochlear
E. Visual
38. A patient with a dislocated shoulder
had been admitted to a hospital. With
the purpose of skeletal muscle relaxati-
on he was given an injection of relaxant
dithylinum acting normally 5-7 minutes.
However, the effect of dithylinum in this
patient lasted up to 8 hours. What is the
most likely cause of the prolonged effect
of dithylinum in this patient?
A. Genetic deficiency of blood choli-
nesterase
B. Reduced activity of microsomal liver
enzymes
C. Reduced drug excretion
D. Material accumulation of the drug
E. Potentiation by another drug
39. As a result of an injury of the knee joi-
nt a patient shows a drawer sign, that is
the anterior and posterior displacement
of the tibia relative to the femur. What li-
gaments are damaged?
A. Cruciate ligaments
B. Arcuate popliteal ligaments
C. Oblique popliteal ligament
D. Interosseous membrane
E. Collateral ligaments
40. The neurosurgical department has
admitted a 54-year-old male complaini-
ng of no sensitivity in the lower eyelid
skin, lateral surface of nose, upper lip.
On examination the physician revealed
the inflammation of the second branch of
the trigeminal nerve. This branch comes
out of the skull through the following
foramen:
A. Round foramen
B. Lacerated foramen
C. Oval foramen
D. Spinous foramen
E. Superior orbital fissure
41. Bacteriological examination of
purulent discharges from the urethra
revealed some gram-negative bean-
shaped bacteria located in the leukocytes.
They can be identified as the causative
agent of the following disease:
5
A. Gonorrhea
B. Syphilis
C. Venereal lymphogranulomatosis
D. Chancroid
E. Trichomoniasis
42. A male patient is 28 years old. Hi-
stological study of a cervical lymph node
revealed a change of its pattern due to the
proliferation of epithelioid, lymphoid cells
and macrophages having nuclei in form of
a horseshoe. In the center of some cell
clusters there were non-structured light-
pink areas with fragments of nuclei. What
disease are these changes typical for?
A. Tuberculosis
B. Hodgkin’s disease
C. Actinomycosis
D. Tumor metastasis
E. Syphilis
43. A 35-year-old male patient has been
referred by an andrologist for the genetic
counselling for the deviations of physi-
cal and mental development. Objectively:
the patient is tall, has asthenic constituti-
on, gynecomastia, mental retardation. Mi-
croscopy of the oral mucosa cells revealed
sex chromatin (single Barr body) in 30%
of cells. What is the most likely diagnosis?
A. Klinefelter syndrome
B. DiGeorge syndrome
C. Down syndrome
D. Recklinghausen’s disease
E. Cushing pituitary basophilism
44. 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?
A. Hemolytic
B. Parenchymal (hepatic)
C. Mechanical
D. Neonatal jaundice
E. Gilbert’s disease
45. A male with a lesion of one of the CNS
parts has asthenia, muscular dystonia,
balance disorder. Which CNS part has
been affected?
A. Cerebellum
B. Black substance
C. Reticular formation
D. Red nuclei
E. Vestibular nuclei
 Krok 1 Medicine 2013
46. A 50-year-old patient has been admi-
nistered laevomycetin for the treatment of
typhoid fever, but on the next day the pati-
ent’s condition worsened, the temperature
rose to 39, 60C. The deterioration of the
patient’s condition can be explained by:
A. Effects of endotoxins of the causative
agent
B. Allergic reaction
C. Insensitivity of the pathogen to
laevomycetin
D. Secondary infection
E. Re-infection
47. A 12-year-old patient has been admi-
tted to a hospital for hemarthrosis of
the knee joint. From early childhood he
suffers from frequent bleedings. Diagnose
the boy’s disease:
A. Hemophilia
B. Hemorrhagic vasculitis
C. Hemolytic anemia
D. B12 (folic acid)-deficiency anemia
E. Thrombocytopenic purpura
48. Examination of a patient with ischemic
heart disease revealed the impaired
venous blood flow in the territory of
the cardiac vein running in the anterior
interventricular sulcus of heart. What vein
is it?
A. V. cordis magna
B. V. cordis media
C. V. cordis parva
D. V. posterior ventriculi sinistri
E. V. obliqua atrii sinistri
49. For the direct injection of medi-
cations into the liver surgeons use the
round ligament of liver. This manipulation
involves bougienage (lumen dilatation) of
the following vessel:
A. V. umbilicalis
B. A. umbilicalis
C. Ductus venosus
D. V. porta
E. A. hepatica propria
50. A patient with lobar pneumonia
has had body temperature of 39oC wi-
th daily temperature fluctuation of no
more than 1o C for 9 days. This fever
can be characterized by the following
temperature curve:
6
A. Persistent
B. Hectic
C. Remittent
D. Hyperpyretic
E. Recurrent
51. The temperature in a production room
is 36oC. Relative air humidity is 80%.
Under these conditions the human body
transfers heat mainly through:
A. Sweat evaporation
B. Heat conduction
C. Radiation
D. Convection
E. -
52. A hospitalized patient bitten by a rabid
animal has an avulsive wound of shin.
What kind of vaccine must be given to
prevent rabies?
A. Anti-rabies vaccine
B. DTaP
C. Td
D. BCG
E. TABte
53. At autopsy the occipital lobe of brain
was found to have a cavity 2,5x1,5 cm
large filled with a transparent liquid. The
cavity had smooth brownish walls. What
process had developed in the brain?
A. Cyst on the site of a hemorrhage
B. Softening of the cerebrocortical grey
matter
C. Brain abscess
D. Paracephalia
E. A cyst on the site of the softening of the
cerebrocortical grey matter
54. A child entering the school for the first
time was given Mantoux test in order to
determine if there was a need for revacci-
nation. The reaction was negative. What
is the meaning of this test result?
A. No cell-mediated immunity to
tuberculosis
B. Availability of cell-mediated immunity
to tuberculosis
C. No antibodies to the tuberculosis
bacteria
D. No anti-toxic immunity to tuberculosis
E. Presence of antibodies to the
tuberculosis bacteria
55. Study of the biopsy material revealed
a granuloma consisting of lymphocytes,
plasma cells, macrophages with foamy
cytoplasm (Mikulicz cells), many hyaline
globules. What disease can you think of?
 Krok 1 Medicine 2013 7

festation of adverse reactions to drugs is

A. Rhinoscleroma called:
B. Leprosy
C. Syphilis A. Idiosyncrasy
D. Tuberculosis B. Allergy
E. Actinomycosis C. Sensibilization
D. Tachyphylaxis
56. Autopsy of a 78-year-old patient E. Tolerance
revealed that retroperitoneal tissue was
soaked with blood, the abdominal aorta 61. A 40-year-old patient with the
had a sacciform protrusion including a progressing staphylococcal purulent peri-
defect with irregular edges. The wall of odontitis developed purulent inflammati-
the aorta was here and there of stone-like on of bone marrow spaces of the alveolar
density. This is the complication of the process, and then of the body of mandi-
following disease: ble. Microscopy revealed thinning of
bone trabeculae, foci of necrosis, bone
A. Atherosclerosis sequesters surrounded by the connecti-
B. Essential hypertension ve tissue capsule. What is the most likely
C. Systemic vasculitis diagnosis?
D. Visceral syphilis
E. Marfan syndrome A. Chronic osteomyelitis
B. Acute osteomyelitis
57. Glycogen polysaccharide is synthesi- C. Parodontome
zed from the active form of glucose. The D. Chronic fibrous periostitis
immediate donor of glucose residues duri- E. Purulent abscess
ng the glycogenesis is:
62. Curariform substances introduced
A. UDP-glucose into a human body cause the relaxati-
B. Glucose-1-phosphate on of all skeletal muscles. What changes
C. ADP-glucose in the neuromuscular synapse cause this
D. Glucose-6-phosphate phenomenon?
E. Glucose-3-phosphate
A. Blockade of N-cholinergic receptors of
58. After the diagnostic tests a 40-year- the synaptic membrane
old male has been referred for the B. Impaired acetylcholine release
lymphography of the thoracic cavity. The C. Blockade of Ca2+ channels of the
surgeon revealed that the tumor had presynaptic membrane
affected an organ whose lymphatic vessels D. Impaired cholinesterase synthesis
drain directly into the thoracic duct. Speci- E. Depolarization of the postsynaptic
fy this organ: membrane
A. Esophagus 63. A number of diseases can be di-
B. Trachea agnosed by evaluating activity of blood
C. Left main bronchus transaminases. What vitamin is one of
D. Heart cofactors of these enzymes?
E. Pericardium
A. B6
59. A patient with biliary dyskinesia B. B2
and constipations has been prescribed a C. B1
cholagogue having also a laxative effect. D. B8
What drug has been administered? E. B5
A. Magnesium sulfate 64. After a car accident a 23-year-old male
B. Allochol presented to the hospital with a cut wound
C. Cholosas of the anteromedial region of shoulder
D. Cholenzyme and arterial bleeding. Which artery was
E. Nicodinum damaged?
60. It is known that individuals with
genetically caused deficiency of glucose-
6-phosphate dehydrogenase may develop
RBC hemolysis in response to the admini-
stration of some antimalarial drugs. Mani-
 Krok 1 Medicine 2013
A. A. brachialis
B. A. radialis
C. A. axillaris
D. A. subscapularis
E. A. profunda brachii
65. During the operation on the small
intestine the surgeon revealed an area
of the mucous membrane with a single
longitudinal fold among the circular folds.
Which portion of the small intestine is this
structure typical for?
A. Pars descendens duodeni
B. Pars horizontalis duodeni
C. Pars ascendens duodeni
D. jejunum
E. Distal ileum
66. 14 days after quinsy a 15-year-old chi-
ld 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?
A. Acute glomerulonephritis
B. Acute interstitial nephritis
C. Lipoid nephrosis
D. Acute pyelonephritis
E. Necrotizing nephrosis
67. A diseased child has a high fever, sore
throat, swelling of submandibular lymph
nodes. Objectively: pharyngeal mucosa
is edematous, moderately hyperemic, the
tonsils are enlarged, covered with grayish
membrane tightly adhering to the tissues
above. Attempts to remove the membrane
produce the bleeding defects. What di-
sease are these presentations typical for?
A. Diphtheria
B. Catarrhal tonsillitis
C. Scarlet fever
D. Meningococcal disease
E. Measles
68. Study of the biopsy material of an
embryo revealed a zone of developmental
abnormality in a somite. The zone was
located close to the endoderm and
the notochord. What formations may
have abnormal development in case of
pregnancy continuation?
8
A. Skeletal tissues
B. Genito-urinary system
C. Skeletal striated muscle tissue
D. Cardiac striated muscle tissue
E. Fibrous connective tissue of skin
69. A smear of sputum from the pati-
ent with suspected lobar pneumonia was
stained with the use of the following
stains and reagents: solution of genti-
an violet, Lugol’s solution, 96o alcohol,
water magenta. What staining method was
applied in this case?
A. Gram
B. Ziehl-Nielsen
C. Romanovsky
D. Neisser
E. Leffler
70. A patient has normally coloured stool
including a large amount of free fatty aci-
ds. The reason for this is a disturbance of
the following process:
A. Fat absorption
B. Fat hydrolysis
C. Biliary excretion
D. Choleresis
E. Lipase secretion
71. Examination of the removed stomach
revealed a deep roundish defect with
regular edges at the lesser curvature of the
antrum. The defect reached the muscular
tunic and was 1,5 cm in diameter. Within
the defect floor there was a translucent
dense area resembling of a hyaline carti-
lage. What process had developed in the
floor of the stomach defect?
A. Local hyalinosis
B. Amyloidosis
C. Mucoid swelling
D. Fibrinoid alterations
E. General hyalinosis
72. By the decarboxylation of glutamate in
the CNS an inhibitory mediator is formed.
Name it:
A. GABA
B. Glutathione
C. Histamine
D. Serotonin
E. Asparagine
73. Thermometry revealed that the
temperature of the exposed skin is by 1-
1,5o lower than the temperature of the
adjacent areas covered with clothing from
natural fabrics. The reason for this is that
the clothes reduce the heat loss through:
 Krok 1 Medicine 2013 9

A. Convection A. Insulin
B. Radiation B. Adrenaline
C. Conduction C. Isadrinum
D. Evaporation D. Glibenclamide
E. - E. Furosemide
74. A specimen of pia mater includes a 79. In order to stimulate breathing in a chi-
vessel whose wall doesn’t have the tuni- ld born with asphyxia, the doctor gave him
ca media, the tunica externa is adherent a drug injection into the umbilical vein.
to the surrounding tissues, the intima is What drug might have been injected?
composed of a basement membrane and
endothelium. What vessel is it? A. Aethimizolum
B. Corazolum
A. Nonmuscular vein C. Cordiaminum
B. Muscular vein with underdeveloped D. Sulfocamphocainum
muscular elements E. Coffeinum
C. Muscular artery
D. Arteriole 80. A patient complains of pain in the ri-
E. Artery of mixed type ght lateral abdomen. Palpation revealed a
dense, immobile, tumor-like formation. A
75. A patient with extensive burns of torso tumor is likely to be found in the followi-
skin exhibits signs of severe intoxication. ng part of the digestive tube:
What stage of the burn disease is this typi-
cal for? A. Colon ascendens
B. Colon transversum
A. Burn toxemia C. Colon descendens
B. Burn shock D. Colon sigmoideum
C. Burn infection E. Caecum
D. Burn emaciation
E. Terminal 81. A patient underwent biopsy of the
soft palate arches for a suspected tumor
76. As a result of a craniocerebral injury (macroscopy revealed an ulcer with a
a patient has a decreased skin sensitivity. dense floor). Study of the biopsy materi-
What area of the cerebral cortex may be al revealed mucosal necrosis with infi-
damaged? ltration of lymphocytes, epithelioid cells,
plasma cells, single neutrophils in the
A. Posterior central gyrus submucosa. There were also apparent si-
B. Occipital region gns of endovasculitis and perivasculitis.
C. Cingulate gyrus The described changes are typical for:
D. Frontal cortex
E. Anterior central gyrus A. Primary syphilis
B. Aphthous stomatitis
77. A histological specimen of the eyeball C. Ulcerative stomatitis
shows a biconvex structure connected to D. Necrotizing ulcerative Vincent stomati-
the ciliary body by the fibers of the Zinn’s tis
zonule and covered with a transparent E. Pharyngeal diphtheria
capsule. Name this structure:
82. Healthy parents with unremarkable
A. Crystalline lens family history have the child with multi-
B. Vitreous body ple developmental defects. Cytogenetic
C. Ciliary body analysis revealed the trisomy 13 in the
D. Cornea somatic cells (Patau syndrome). What
E. Sclera phenomenon has caused the defects?
78. A comatose patient was taken to the A. Abnormal gametogenesis
hospital. He has a history of diabetes B. Somatic mutation
mellitus. Objectively: Kussmaul breathi- C. Recessive mutation
ng, low blood pressure, acetone odor of D. Dominant mutation
breath. After the emergency treatment E. Chromosomal mutation
the patient’s condition improved. What
drug had been administered to the pati- 83. A specimen shows an organ covered
ent? with the connective tissue capsule with
 Krok 1 Medicine 2013
trabeculae radiating inward the organ.
There is also cortex containing some
lymph nodules, and medullary cords made
of lymphoid cells. What organ is under
study?
A. Lymph node
B. Thymus
C. Spleen
D. Red bone marrow
E. Tonsils
84. A 25-year-old patient consulted a
doctor about dysmenorrhea and infertili-
ty. Examination revealed that the patient
was 145 cm high and had underdeveloped
secondary sex characteristics, alar folds on
the neck. Cytological study didn’t reveal
any Barr bodies in the somatic cells. What
diagnosis was made?
A. Turner’s syndrome
B. Klinefelter syndrome
C. Morris syndrome
D. Trisomy X syndrome
E. -
85. To prevent attacks of acute pancreati-
tis a doctor prescribed the patient trasylol
(contrycal, gordox), which is an inhibitor
of:
A. Trypsin
B. Elastase
C. Carboxypeptidase
D. Chymotrypsin
E. Gastricsin
86. A patient died from progressive heart
failure. Autopsy revealed that the heart
was enlarged in diameter, flabby. The
muscle section exhibited irregular blood
supply. Histological study of myocardium
revealed hyperemia, the stroma was found
to have lymphohistiocytic infiltrates wi-
th degeneration of cardiomyocytes. The
revealed morphological changes are indi-
cative of:
A. Non-purulent interstitial myocarditis
B. Venous plethora
C. Cardiomyoliposis
D. Cardiosclerosis
E. Myocardial infarction
87. A 13-year-old teenager underwent X-
ray examination of the hip joint. Exami-
nation revealed a 3 mm wide radiolucent
zone between the head and the shaft of
femur. This situation should be evaluated
as:
10
A. Normal (incomplete process of ossifi-
cation)
B. Fracture of the femoral neck
C. Fissured fracture of the femoral neck
D. Dislocation of the femoral head
E. Radiographic film artifact
88. A surgeon examined the patient and
found the injury of the upper third of the
kidney. Considering the syntopy of the
left kidney, the intactness of the following
organ should be checked at the same time:
A. Stomach
B. Liver
C. Small intestine
D. Transverse colon
E. Descending colon
89. A patient with urolithiasis has
unbearable spasmodic pain. To prevent
pain shock, he has been given an injection
of atropine along with a narcotic analgesic
having antispasmodic effect. What drug
was it?
A. Promedol
B. Nalorphine
C. Tramadol
D. Ethylmorphine hydrochloride
E. Morphine hydrochloride
90. Despite the administration of cardi-
otonics and a thiazide diuretic a pati-
ent with chronic heart failure has persi-
stent edemata, there is a risk of ascites.
What medication should be administered
in order to enhance the diuretic effect of
the drugs used?
A. Spironolactone
B. Furosemide
C. Amiloride
D. Clopamide
E. Manithol
91. A patient with a pathology of
the cardiovascular system developed
edemata of the lower extremities. What
is the mechanism of cardiac edema
development?
A. Increased hydrostatic pressure at the
venous end of the capillary
B. Increased oncotic pressure
C. Increased hydrostatic pressure at the
arterial end of the capillary
D. Reduced osmotic pressure
E. Lymph efflux disorder
92. During the fight, a man had a cardi-
ac arrest due to the strong blow to the
upper region of the anterior abdominal
 Krok 1 Medicine 2013
wall. Which of the following mechanisms
has led to the cardiac arrest?
A. Parasympathetic unconditioned reflexes
B. Sympathetic unconditioned reflexes
C. Parasympathetic conditioned reflexes
D. Sympathetic conditioned reflexes
E. Peripheral reflexes
93. A pregnant woman underwent AB0
blood typing. Red blood cells were
agglutinated with standard sera of the I
and II blood groups, and were not aggluti-
nated with the III group serum. What is
the patient’s blood group?
A. B(III)
B. 0(I)
C. A(II)
D. AB(IV)
E. -
94. Amniocentesis revealed two sex
chromatin bodies (Barr bodies) in each
cell of the sample. What disease is this
character typical for?
A. Trisomy X
B. Klinefelter syndrome
C. Turner’s syndrome
D. Down’s syndrome
E. Patau syndrome
95. A hospital has admitetd a patient
complaining of abdominal bloating, di-
arrhea, 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?
A. Indole
B. Bilirubin
C. Cadaverine
D. Agmatine
E. Putrescine
96. An attack of tachycardia that occurred
in a patient was stopped by pressing on his
eyeballs. Which of the following reflexes
underlies this phenomenon?
A. Aschner
B. Goltz
C. Bainbridge
D. Hering
E. Bernard’s
97. A male patient has been di-
agnosed with acute post-streptococcal
glomerulonephritis. It is most likely that
the lesion of the basement membrane
11
of renal corpuscles was caused by the
following allergic reaction:
A. Immune complex
B. Anaphylactic
C. Cytotoxic
D. Delayed
E. Stimulating
98. An unconscious patient was taken by
ambulance to the hospital. On objecti-
ve examination the patient was found
to have no reflexes, periodical convulsi-
ons, irregular breathing. After laboratory
examination the patient was diagnosed
with hepatic coma. Disorders of the
central nervous system develop due to the
accumulation of the following metabolite:
A. Ammonia
B. Urea
C. Glutamine
D. Bilirubin
E. Histamine
99. A 20-year-old male patient complai-
ns of general weakness, rapid fatigabi-
lity, irritability, decreased performance,
bleeding gums, petechiae on the skin.
What vitamin deficiency may be a cause
of these changes?
A. Ascorbic acid
B. Riboflavin
C. Thiamine
D. Retinol
E. Folic acid
100. It is known that the monoami-
ne oxidase (MAO) enzyme plays an
important part in the metabolism of
catecholamine neurotransmitters. In what
way does the enzyme inactivate these
neurotransmitters (norepinephrine, epi-
nephrine, dopamine)?
A. Oxidative deamination
B. Addition of an amino group
C. Removal of a methyl group
D. Carboxylation
E. Hydrolysis
101. The cellular composition of exudate
largely depends on the etiological factor
of inflammation. What leukocytes are the
first to get into the focus of inflammation
caused by pyogenic bacteria?
 Krok 1 Medicine 2013
A. Neutrophil granulocytes
B. Monocytes
C. Myelocytes
D. Eosinophilic granulocytes
E. Basophils
102. At the end of the working day a
worker of a hot work shop has been deli-
vered to a hospital. The patient complains
of a headache, dizziness, nausea, general
weakness. Objectively: the patient is
conscious, his skin is hyperemic, dry, hot to
the touch. Heart rate is of 130/min. Respi-
ration is rapid, superficial. What disorder
of thermoregulation is most likely to have
occurred in this patient?
A. Reduced heat transfer
B. Increased heat transfer and reduced
heat production
C. Increased heat transfer and heat
production
D. Increased heat production with no
changes to the heat transfer
E. Reduced heat production with no
changes to the heat transfer
103. 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?
A. Alveolar macrophages
B. Alveolocytes type I
C. Endothelial cells
D. Clara cells
E. Alveolocytes type II
104. A 35-year-old male developed acute
heart failure while running for a long ti-
me. What changes in the ionic compositi-
on can be observed in the cardiac muscle?
A. Accumulation of Na+ and Ca2+ ions in
the myocardium cells
B. Accumulation of K + and Mg 2+ ions in
the myocardium cells
C. Reduction of Na+ and Ca2+ ions in the
myocardium cells
D. Reduction of K + and Mg 2+ ions in the
extracellular space
E. Reduction of Na+ and Ca2+ ions in the
extracellular space
105. Workers of a conveyor workshop
received recommendations for the effecti-
ve organization of working time and hi-
gher working efficiency. What peculiari-
ty of work in this workshop causes the
greatest stress for the workers?
12
A. Monotony of work
B. State of "operating rest"
C. Increased intellectual component
D. Increased responsibility
E. Social inefficiency of labor
106. Mother of a boy who had recently
returned from a summer camp found
some small whitish insects up to 3 mm
long on the child’s clothing. Specify the
parasite:
A. Pediculus humanus humanus
B. Phtirus pubis
C. Pulex irritans
D. Cimex lectularius
E. Blattella germanica
107. Histological examination of the
removed skin neoplasm revealed clusters
and cords of atypical cells of stratified
squamous epithelium, growing into the
underlying tissue. What diagnosis can be
assumed?
A. Non-keratinizing squamous cell carci-
noma
B. Keratinizing squamous cell carcinoma
C. Carcinoma in situ
D. Papilloma
E. Adenoma
108. An 18-year-old male has been di-
agnosed with Marfan syndrome. Exami-
nation revealed a developmental di-
sorder of connective tissue and eye lens
structure, abnormalities of the cardi-
ovascular system, arachnodactylia. What
genetic phenomenon has caused the
development of this disease?
A. Pleiotropy
B. Complementarity
C. Codominance
D. Multiple allelism
E. Incomplete dominance
109. A patient has severe catarrhal
symptoms. Material growth on Bordet-
Gengou agar showed mercury-drop-
like colonies. Examination of the blood
smears revealed some small ovoid gram-
positive bacilli sized 1-3 microns. What mi-
croorganisms were isolated?
A. Bordetella
B. Corynebacteria
C. Mycobacteria
D. Meningococcus
E. Brucella
110. A 66-year-old patient with Parki-
 Krok 1 Medicine 2013
nson’s disease shows an improvement in
locomotor activity after prolonged use
of a certain drug which is converted to
dopamine by the decarboxylation. What
drug has the patient taken?
A. Levodopa
B. Naloxone
C. Celecoxib
D. Droperidol
E. Chlorpromazine
111. Enzymatic jaundices are accompani-
ed by abnormal activity of UDP-
glucuronyl transferase. What compound
is accumulated in blood serum in case of
these pathologies?
A. Unconjugated bilirubin
B. Conjugated bilrubin
C. Dehydrobilirubin
D. Hydrobilirubin
E. Choleglobin
112. For the study of serum proteins
various physical and physicochemical
methods can be used. In particular, serum
albumins and globulins can be separated
by this method:
A. Electrophoresis
B. Polarography
C. Dialysis
D. Spectrography
E. Refractometry
113. Negative environmental factors have
caused the dysfunction of myosatellite
cells. What function of the whole muscle
fibre is likely to be changed in this case?
A. Regeneration
B. Contraction
C. Trophism
D. Contractile thermogenesis
E. Relaxation
114. The laboratory for especially
dangerous infections conducts mi-
croscopic examination of pathological
material from a patient with suspected
plague. The sample was stained by Burri-
Gins technique. What property of the
causative agent can be identified by this
technique?
A. Capsule formation
B. Spore formation
C. Acid resistance
D. Alkali resistance
E. Presence of volutin granules
115. Autopsy of a 62-year-old woman
13
revealed a dense well-circumscribed node
of 6 cm in diameter in the cranial cavity.
The node was attached to the dura mater
and histologically consisted of clusters and
micro-concentric structures of endotheli-
al cells, psammoma bodies. What kind of
tumor was found at autopsy?
A. Meningioma
B. Glioblastoma
C. Medulloblastoma
D. Melanoma
E. Cancer metastasis
116. Inherited diseases, such as
mucopolysaccharidoses, are manifested
in metabolic disorders of connective ti-
ssue, bone and joint pathologies. The si-
gn of this disease is the excessive urinary
excretion of the following substance:
A. Glycosaminoglycans
B. Amino acids
C. Glucose
D. Lipids
E. Urea
117. An animal has an increased tonus
of extensor muscles. This is the result of
enhanced information transmission to the
motoneurons of the spinal cord through
the following descending pathways:
A. Vestibulospinal
B. Medial corticospinal
C. Reticulospinal
D. Rubrospinal
E. Lateral corticospinal
118. A specimen of a parenchymal
organ shows poorly delineated hexagonal
lobules surrounding a central vein, and
the interlobular connective tissue contai-
ns embedded triads (an 0artery, a vein and
an excretory duct). What organ is it?
A. Liver
B. Pancreas
C. Thymus
D. Spleen
E. Thyroid
119. A patient has been admitted to
the infectious diseases department for
malaise, fever up to 38o C, jaundice. A
few months ago, the patient underwent
blood transfusion. The doctor suspected
viral hepatitis B. What are the principal
methods of laboratory diagnosis of hepati-
tis B?
 Krok 1 Medicine 2013
A. Serological and gene diagnostics
B. Virus isolation in cell culture and its
identification by the cytopathic effects
C. Detection of virions in blood by electron
microscopy
D. Isolation of the virus in laboratory
animals (neutralization reaction)
E. Isolation of the virus in chicken embryos
120. After resection of the middle thi-
rd of the femoral artery obliterated by a
thrombus the limb is supplied with blood
through the bypasses. What artery plays
the main part in the restoration of the
blood flow?
A. Deep femoral artery
B. Superficial iliac circumflex artery
C. Descending genicular artery
D. Superficial epigastric artery
E. External pudendal artery
121. During the intravenous transfusi-
on of the saline the patient’s conditi-
on deteriorated dramatically, and the
patient died from asphyxiation. Autopsy
revealed acute venous congestion of
internal organs with the dramatic ri-
ght heart dilatation. When the right
ventricle was punctured underwater,
the bubbles escaped. What pathological
process occurred in the patient?
A. Air embolism
B. Gaseous embolism
C. Adipose embolism
D. Tissue embolism
E. Thromboembolism
122. At the post-mortem examination the
stomach of a patient with renal failure was
found to have a yellow-brown coating on
the thickened mucosa. The coating was
firmly adhering to its surface and had si-
gnificant thickness. Microscopy revealed
congestion and necrosis of mucosal and
submucosal layers, fibrin presence. What
is the most likely diagnosis?
A. Fibrinous gastritis
B. Croupous gastritis
C. Gastric abscess
D. Esogastritis
E. Corrosive gastritis
123. Infectious diseases are treated with
antibiotics (streptomycin, erythromycin,
chloramphenicol). They inhibit the
following stage of protein synthesis:
14
A. Translation
B. Transcription
C. Replication
D. Processing
E. Splicing
124. 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:
A. Lactic acid
B. Pyruvic acid
C. Glutamic acid
D. Citric acid
E. Fumaric acid
125. A patient has been hospitalized for a
suspected tumor of the prostate. During
the surgery, it was revealed that the tumor
invaded the bladder. Which part of the
bladder was affected?
A. Cervix
B. Apex
C. Bottom
D. Body
E. -
126. A casualty with an injury of the
temporal region has been diagnosed with
epidural hematoma. Which of the arteries
is most likely to be damaged?
A. Medial membranous artery
B. Medial cerebral artery
C. Superficial temporal artery
D. Anterior membranous artery
E. Posterior auricular artery
127. A 19-year-old male was found to
have an elevated level of potassium in
the secondary urine. These changes mi-
ght have been caused by the increase in
the following hormone level:
A. Aldosterone
B. Oxytocin
C. Adrenaline
D. Glucagon
E. Testosterone
128. Analysis of the ECG revealed the
missing of several PQRST cycles. The
remaining waves and complexes are not
changed. Specify the type of arrhythmia:
 Krok 1 Medicine 2013
A. Sinoatrial block
B. Atrial fibrillation
C. Atrioventricular block
D. Atrial premature beat
E. Intra-atrial block
129. 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:
A. Ventricles
B. Atria
C. Atrio-ventricular node
D. Right ventricle
E. Left ventricle
130. 6 hours after the myocardial infarcti-
on a patient was found to have elevated
level of lactate dehydrogenase in blood.
What isoenzyme should be expected in
this case?
A. LDH1
B. LDH2
C. LDH3
D. LDH4
E. LDH5
131. A 46-year-old female is scheduled
for a maxillofacial surgery. It is known
that the patient is prone to high blood
coagulation. What natural anticoagulant
can be used to prevent blood clotting?
A. Heparin
B. Hirudin
C. Sodium citrate
D. Fibrinolysin
E. None of the above-listed substances
132. A 50-year-old patient with food poi-
soning is on a drip of 10% glucose soluti-
on. It not only provides the body with
necessary energy, but also performs the
function of detoxification by the producti-
on of a metabolite that participates in the
following conjugation reaction:
A. Glucuronidation
B. Sulfation
C. Methylation
D. Glycosylation
E. Hydroxylation
133. To assess the effectiveness of breathi-
ng in patients, the indicator of functional
residual capacity is used. It includes the
following volumes:
15
A. Expiratory reserve volume and residual
volume
B. Inspiratory reserve volume and residual
volume
C. Inspiratory reserve volume, tidal
volume, residual volume
D. Expiratory reserve volume and tidal
volume
E. Inspiratory reserve volume and tidal
volume
134. It is required to evaluate the level of
tissue excitability. For this purpose one
should determine:
A. Depolarization threshold
B. Resting potential
C. Critical level of depolarization
D. Action potential amplitude
E. Action potential duration
135. Due to the use of poor-quality
measles vaccine for preventive vaccinati-
on, a 1-year-old child developed an autoi-
mmune renal injury. The urine was found
to contain macromolecular proteins. What
process of urine formation was disturbed?
A. Filtration
B. Reabsorption
C. Secretion
D. Reabsorption and secretion
E. Secretion and filtration
136. A patient has been administered an
anti-inflammatory drug that blocks the
action of cyclooxygenase. Specify this
anti-inflammatory agent:
A. Aspirin
B. Analgene
C. Allopurinol
D. Thiamin
E. Creatine
137. A pneumonia patient has been
administered acetylcysteine as a part
of complex therapy. What principle of
therapy was taken into consideration
when applying this drug?
A. Pathogenetic
B. Symptomatic
C. Etiotropic
D. Antimicrobial
E. Immunomodulatory
138. A 26-year-old female patient with
bronchitis has been administered a broad
spectrum antibiotic as a causal treatment
drug. Specify this drug:
 Krok 1 Medicine 2013
A. Doxycycline
B. Interferon
C. BCG vaccine
D. Ambroxol
E. Dexamethasone
139. A 65-year-old male suddenly lost
the vision in one eye due to the reti-
nal detachment. The patient underwent
enucleation. Histological examination
of the removed eye retina and choroid
revealed clusters of atypical cells wi-
th marked polymorphism of cells and
nuclei, with a moderate number of mi-
toses including the pathological ones. The
cell cytoplasm and intercellular medi-
um contained brown pigment giving a
positive DOPA reaction. Perls’ reaction
was negative. What is the most likely di-
agnosis?
A. Melanoma
B. Pigmented mole
C. Hemorrhage
D. Cysticercosis
E. Wilson’s disease
140. A child cut his leg with a piece of
glass while playing and was brought to the
clinic for the injection of tetanus toxoid.
In order to prevent the development
of anaphylactic shock the serum was
administered by Bezredka method. What
mechanism underlies this method of
desensitization of the body?
A. Binding of IgE fixed to the mast cells
B. Blocking the mediator synthesis in the
mast cells
C. Stimulation of immune tolerance to the
antigen
D. Stimulation of the synthesis of antigen-
specific IgG
E. Binding of IgE receptors to the mast
cells
141. Microscopy of the myocardium of
a patient who had died from heart fai-
lure revealed foci of fibrinoid necrosis
located diffusely in the interstitial stroma,
and often around the vessels. Such
foci were surrounded by lymphocytes,
macrophages, histiocytes. Pericardium
was found to have signs of sero-fibrinous
pericarditis. What is the most likely di-
agnosis?
A. Rheumatic heart disease
B. Myocardial infarction
C. Cardiomyopathy
D. Cardiosclerosis
E. -
16
142. One of the factors that cause obesity
is the inhibition of fatty acids oxidation
due to:
A. Low level of carnitine
B. Impaired phospholipid synthesis
C. Excessive consumption of fatty foods
D. Choline deficiency
E. Lack of carbohydrates in the diet
143. The genetic defect of pyruvate
carboxylase deficiency is the cause of
delayed physical and mental development
and early death in children. This defect
is characterized by lacticemia, lactaci-
duria, disorder of a number of metabolic
pathways. In particular, the following
process is inhibited:
A. Citric acid cycle and gluconeogenesis
B. Glycolysis and glycogenolysis
C. Glycogenesis and glycogenolysis
D. Lipolysis and lipogenesis
E. Pentose phosphate pathway and
glycolysis
144. Deficiency of linoleic and linolenic
acids in the body leads to the skin
damage, hair loss, delayed wound heali-
ng, thrombocytopenia, low resistance to
infections. These changes are most likely
to be caused by the impaired synthesis of
the following substances:
A. Eicosanoids
B. Interleukins
C. Interferons
D. Catecholamines
E. Corticosteroids
145. During ventricular systole, the cardi-
ac muscle does not respond to additional
stimulation because it is in the phase of:
A. Absolute refractoriness
B. Relational refractoriness
C. Hyperexcitability
D. Subnormal excitability
E. There is no correct answer
146. A mother had taken synthetic
hormones during pregnancy. Her
daughter was born with hirsutism formally
resembling of adrenal syndrome. Such
manifestation of variability is called:
A. Phenocopy
B. Mutation
C. Recombination
D. Heterosis
E. Replication
147. Since a patient has had myocardial
 Krok 1 Medicine 2013
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:
A. Complete atrioventricular
B. Partial atrioventricular
C. Sino-atrial
D. Intra-atrial
E. Intraventricular
148. A 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 IIa
B. Hyperlipoproteinemia type I
C. Hyperlipoproteinemia type IIb
D. Hyperlipoproteinemia type IV
E. Cholesterol, hyperlipoproteinemia
149. A 12-year-old child has a viral infecti-
on complicated by obstructive bronchi-
tis. Bronchospasm can be eliminated by
inhalations of a drug from the following
pharmacological group:
A. β2 -agonists
B. M-anticholinergics
C. N-cholinomimetics
D. β2 -adrenergic blockers
E. Analeptics
150. In course of an experiment there has
been an increase in the nerve conducti-
on velocity. This may be caused by an
increase in the concentration of the
following ions that are present in the
solution around the cell:
A. Na+
B. K + and Cl−
C. K + and Na+
D. Ca2+ and Cl−
E. Ca2+
151. A male working as a blacksmith has
been tested for auditory acuity. The tests
revealed 50% hearing loss in the low-
frequency range and a near-normal audi-
tory acuity in the high-frequency range.
This condition has been caused by the
damage to the following structures of the
auditory system:
17
A. Corti’s organ - closer to helicotrema
B. Corti’s organ - closer to the oval
foramen
C. Median part of the Corti’s organ
D. Muscles of the middle ear
E. Eardrum
152. In our country, routine preventi-
ve vaccinations against poliomyelitis
ivolve using live vaccine that is admini-
stered orally. What immunoglobulins are
responsible for the development of local
post-vaccination immunity in this case?
A. Secretory IgA
B. IgM
C. IgG
D. Serum IgA
E. IgE
153. An experiment proved that UV-
irradiated skin cells of patients with
xeroderma pigmentosum restore the nati-
ve structure of DNA slower than the cells
of healthy people due to the defect in
repair enzyme. What enzyme takes part
in this process?
A. Endonuclease
B. RNA ligase
C. Primase
D. DNA polymerase
E. DNA gyrase
154. A patient who has recently come
from an endemic area presents with
elevated body temperature, headache,
chills, malaise, that is with the symptoms
which are typical for a common cold.
What laboratory tests are necessary to
confirm or to refute the diagnosis of
malaria?
A. Microscopy of blood smears
B. Study of lymph node punctate
C. Urinalysis
D. Study of cerebrospinal fluid
E. Microscopy of bone marrow punctate
155. What condition may develop 15-30
minutes after re-administration of the
antigen as a result of the increased level of
antibodies, mainly IgE, that are adsorbed
on the surface of target cells, namely ti-
ssue basophils (mast cells) and blood
basophils?
A. Anaphylaxis
B. Antibody-dependent cytotoxicity
C. Delayed-type hypersensitivity
D. Immune complex hyperresponsiveness
E. Serum sickness
 Krok 1 Medicine 2013
156. 10 days after having quinsy caused
by beta-hemolytic streptococcus a 6-
year-old child exhibited symptoms of
glomerulonephritis. What mechanism of
glomerular lesion is most likely in this
case?
A. Immunocomplex
B. Cellular cytotoxicity
C. Anaphylaxis
D. Atopy
E. Antibody-dependent cell-mediated
cytolysis
157. A 22-year-old woman ate some
seafood. 5 hours later the trunk and the
distal parts of limbs got covered with
small itchy papules which were partially
fused together. After one day, the rash
disappeared spontaneously. Specify the
hypersensitivity mechanism underlying
these changes:
A. Atopy (local anaphylaxis)
B. Systemic anaphylaxis
C. Cellular cytotoxicity
D. Immune complex hypersensitivity
E. Antibody-dependent cell-mediated
cytolysis
158. A hypertensive patient had been
keeping to a salt-free diet and taki-
ng antihypertensive drugs together with
hydrochlorothiazide for a long time. This
resulted in electrolyte imbalance. What
disorder of the internal environment
occurred in the patient?
A. Hypochloremic alkalosis
B. Metabolic acidosis
C. Hyperkalemia
D. Hypermagnesemia
E. Increase in circulating blood volume
159. A miner consulted a physician about
the appearance of body rash followed by
a loss of appetite, bloating, duodenal pain,
frequent bowel movements, dizziness.
Ovoscopic probes of feces and duodenal
contents revealed some eggs covered with
a transparent membrane through which
4-8 germinal cells could be seen. What
disease is likely to have occurred in the
patient?
A. Ancylostomiasis
B. Strongyloidiasis
C. Trichocephaliasis
D. Hymenolepiasis
E. Enterobiasis
160. Children with Lesch-Nyhan
syndrome have a severe form of hyperuri-
18
cemia accompanied by the formation of
tophi, urate calculi in the urinary tracts,
as well as serious neuro-psychiatric di-
sorders. The cause of this disease is the
reduced activity of the following enzyme:
A. Hypoxanthine-guanine phosphori-
bosyltransferase
B. Xanthine oxidase
C. Dihydrofolate reductase
D. Thymidylate synthase
E. Karbamoyl phosphate synthetase
161. In a car accident a man got injured
and lost a lot of blood. What changes in
peripheral blood are most likely to occur
on the 2nd day after the injury?
A. Erythropenia
B. Hypochromia
C. Anisocytosis
D. Microplania
E. Significant reticulocytosis
162. In the surgical ward, the dressi-
ng material was undergoing sterilizati-
on in an autoclave. Through an oversi-
ght of a nurse the mode of sterilization
was changed and the temperature in the
autoclave reached only 100oC instead of
the due 120OC. What microorganisms can
stay viable under these conditions?
A. Bacilli and clostridia
B. Staphylococci and streptococci
C. Mold and yeast fungi
D. Salmonella and klebsiella
E. Corynebacteria and mycobacteria
163. As a result of a mechanical injury
an over 10 cm long portion of a peri-
pheral nerve was damaged. This led to the
impairment of the upper limb activity. The
patient was offered nerve transplantati-
on. What glial cells will participate in
regeneration and provide the trophism of
the injured limb?
A. Schwann cells
B. Fibrous cells
C. Protoplasmic cells
D. Microglia
E. Ependymal cells
164. A 26-year-old woman at 40 weeks
pregnant has been delivered to the
maternity ward. Objectively: the uterine
cervix is opened, but the contractions are
absent. The doctor has administered her
a hormonal drug to stimulate the labor.
Name this drug:
 Krok 1 Medicine 2013 19

A. Oxytocin contents revealed some pear-shaped

B. Hydrocortisone
C. Estrone
D. Testosterone
E. ACTH
165. A patient has recurrent attacks of
epileptic seizures and stays unconscious
between them. In order to stop convulsi-
ons the drugs of the following group
should be used in the first place:
A. Tranquilizers
B. Neuroleptics
C. Muscle relaxants
D. Sedatives
E. Analeptics
166. A patient with arthritis and varicose
veins has been taking a non-steroidal anti-
inflammatory drug for a long time, which
caused thrombosis of skin veins. Which
of the following drugs might have caused
this complication?
A. Celecoxib
B. Indomethacin
C. Aspirin
D. Phenylbutazone
E. Ibuprofen
167. Students study the stages of
gametogenesis. They analyze a cell havi-
ng a haploid number of chromosomes,
and each chromosome consists of two
chromatids. The chromosomes are located
in the equatorial plane of the cell. Such si-
tuation is typical for the following stage of
meiosis:
A. Metaphase of the second division
B. Metaphase of the first division
C. Anaphase of the first division
D. Anaphase of the second division
E. Prophase of the first division
168. A 35-year-old female patient
underwent biopsy of the breast nodules.
Histological examination revealed
enhanced proliferation of the small duct
epithelial cells and acini, accompanied
by the formation of glandular structures
of various shapes and sizes, which were
located in the fibrous stroma. What is the
most likely diagnosis?
A. Fibroadenoma
B. Adenocarcinoma
C. Cystic breast
D. Invasive ductal carcinoma
E. Mastitis
169. Examination of the duodenal
protozoa with two nuclei and four pai-
rs of flagella. The organisms had also
two axostyles between the nuclei and a
ventral adhesive disc. What protozoan
representative was found in the patient?
A. Lamblia
B. Toxoplasma
C. Leishmania
D. Intestinal trichomonad
E. Trypanosome
170. A specimen of an onion rootlet
includes a cell in which the fully
condensed chromosomes are located in
the equatorial plane making the monaster.
What phase of the mitotic cycle is the cell
in?
A. Metaphase
B. Early telophase
C. Prophase
D. Interphase
E. Late telophase
171. When examining a patient, the doctor
revealed a tumor of the bronchus which
borders on the aorta. Which bronchus is
affected?
A. Left principal
B. Right principal
C. Right upper lobar
D. Left upper lobar
E. Middle lobar
172. A 54-year-old female was brought to
the casualty department after a car acci-
dent. A traumatologist diagnosed her with
multiple fractures of the lower extremiti-
es. What kind of embolism is most likely
to develop in this case?
A. Adipose
B. Tissue
C. Thromboembolism
D. Gaseous
E. Air
173. Microscopy of the bronchial
wall revealed atrophy of the mucosa,
metaplastic change from columnar to
squamous epithelium, an increase in
the number of goblet cells, diffuse
infiltration of the bronchial wall wi-
th lymphoplasmacytic elements wi-
th a large number of neutrophilic
granulocytes, pronounced sclerosis. Spesi-
fy the morphological form of bronchitis:
 Krok 1 Medicine 2013
A. Chronic purulent bronchitis
B. Acute bronchitis
C. Polypoid chronic bronchitis
D. Acute purulent bronchitis
E. Chronic bronchitis
174. Due to the blockage of the common
bile duct (which was radiographically
confirmed), the biliary flow to the
duodenum was stopped. We should expect
the impairment of:
A. Fat emulsification
B. Protein absorption
C. Carbohydrate hydrolysis
D. Secretion of hydrochloric acid
E. Salivation inhibition
175. Typical manifestations of food poi-
soning caused by C. botulinum are
double vision, abnormal functioning of
the swallowing and breathing. These
symptoms develop as a result of:
A. Exotoxin effects
B. Enterotoxin effects
C. Enterotoxic shock development
D. Activation of adenylate cyclase
E. Pathogen adhesion to the enterocyte
receptors
176. At the stage of translation in the
rough endoplasmic reticulum, the ri-
bosome moves along the mRNA. Amino
acids are joined together by peptide bonds
in a specific sequence, and thus polypepti-
de synthesis takes place. The sequence of
amino acids in a polypeptide corresponds
to the sequence of:
A. mRNA codons
B. tRNA nucleotides
C. tRNA anticodons
D. rRNA nucleotides
E. rRNA anticodons
177. After the prolonged vomiting a
pregnant 26-year-old woman was found
to have the reduced volume of circulati-
ng blood. What change in the total blood
volume can be the case?
A. Polycythemic hypovolemia
B. Simple hypovolemia
C. Oligocythemic hypovolemia
D. Polycythemic hypervolemia
E. Oligocythemic hypervolemia
178. On allergological examination a pati-
ent has been diagnosed with pollinosis.
Specific desensitization can be performed
by:
20
A. Intermittent administration of allergen
B. Antihistamines
C. Glucocorticoids
D. Administration of saline
E. -
179. A patient consulted a physici-
an about chest pain, cough, fever.
Roentgenography of lungs revealed eosi-
nophilic infiltrates which were found to
contain the larvae. What kind of helmi-
nthiasis are these presentations typical
for?
A. Ascariasis
B. Echinococcosis
C. Fascioliasis
D. Cysticercosis
E. Trichinosis
180. A patient with signs of osteoporosis
and urolithiasis has been admitted
to the endocrinology department.
Blood test revealed hypercalcemia and
hypophosphatemia. These changes are
associated with abnormal synthesis of the
following hormone:
A. Parathyroid hormone
B. Calcitonin
C. Cortisol
D. Aldosterone
E. Calcitriol
181. Histological examination of the bi-
opsy material obtained from the lower
third of the esophagus of a 57-year-old
male with the symptoms of continuous
reflux revealed the change of the strati-
fied squamous epithelium to the single-
layer columnar glandular epithelium wi-
th signs of mucus production. Specify
the pathological process in the mucous
membrane:
A. Metaplasia
B. Hyperplasia
C. Hypertrophy
D. Organization
E. Regeneration
182. A 30-year-old female exhibits signs
of virilism (growth of body hair, balding
temples, menstrual disorders). This condi-
tion can be caused by the overproduction
of the following hormone:
A. Testosterone
B. Oestriol
C. Relaxin
D. Oxytocin
E. Prolactin
 Krok 1 Medicine 2013
183. A patient with bacterial periodontitis
has been administered iontophoresis wi-
th the use of iodine solution. Specify the
mechanism of therapeutic action of this
agent:
A. Substitution of hydrogen atoms when
the protein amino group contains a ni-
trogen atom
B. Reduction of the nitro group under the
effect of nitroreductase
C. Albumin formation
D. Changing the surface tension of the
bacterial cell membrane
E. Inhibition of the cell wall formation
184. A patient with extensive myocardi-
al infarction has developed heart failure.
What pathogenetic mechanism contri-
buted to the development of heart failure
in the patient?
A. Reduction in the mass of functioning
myocardiocytes
B. Pressure overload
C. Volume overload
D. Acute cardiac tamponade
E. Myocardial reperfusion injury
185. A patient who had been continuously
taking drugs blocking the production of
angiotensin II developed bradycardia and
arrhythmia. A likely cause of these di-
sorders is:
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
E. Hypercalcemia
186. A patient has arterial hypertension.
What long-acting drug from the group
of calcium channel blockers should be
prescribed?
A. Amlodipine
B. Octadine
C. Pyrroxanum
D. Atenolol
E. Reserpine
187. Human skin has a high breaking
strength. It is known that the skin consi-
sts of epithelial tissue and two kinds of
connective tissue. Which of the following
tissues provides the skin strength?
A. Unformed dense connective tissue
B. Stratified squamous epithelium
C. Loose connective tissue
D. Single-layer epithelium
E. Transitional epithelium
21
188. As a result of a home injury, a patient
suffered a significant blood loss, which led
to a fall in blood pressure. Rapid blood
pressure recovery after the blood loss is
provided by the following hormones:
A. Adrenaline, vasopressin
B. Cortisol
C. Sex hormones
D. Oxytocin
E. Aldosterone
189. A patient with constant headaches,
pain in the occipital region, tinnitus, dizzi-
ness has been admitted to the cardiology
department. Objectively: AP- 180/110 mm
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:
A. Renin-angiotensin
B. Hemostatic
C. Sympathoadrenal
D. Kinin
E. Immune
190. 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 cardiorespi-
ratory reactions in this patient?
A. Cerebral cortex
B. Cerebellum
C. Lateral hypothalamic nuclei
D. Specific thalamic nuclei
E. Quadrigemina of mesencephalon
191. A patient consulted a dentist about
limited mouth opening (trismus). He has
a history of a stab wound of the lower
extremity. What infection may cause these
symptoms?
A. Tetanus
B. Brucellosis
C. Whooping cough
D. Wound anaerobic infection
E. Tularemia
192. Anatomical dead space is the portion
of the air that is left in the airways after
expiration. The reduction of the anatomi-
cal dead space is typical for the following
situation:
 Krok 1 Medicine 2013
A. Tracheostomy
B. Forward flexion of head
C. Turning the lying patient on his left side
D. Turning the lying patient on his right
side
E. Breathing through the mouth
193. Analysis of the experimental spi-
rogram of a 55-year-old person revealed
a decrease in tidal volume and respiratory
amplitude compared to the situation of
ten years ago. The change in these indi-
cators is caused by:
A. Decreased force of respiratory muscle
contraction
B. Gas composition of the air
C. Physical build of a person
D. Height of a person
E. Body mass of a person
194. A patient underwent a course of
treatment for atherosclerosis. Laboratory
tests revealed an increase in the anti-
atherogenic lipoprotein fraction in the
blood plasma. The treatment efficacy is
confirmed by the increase in:
A. HDL
B. VLDL
C. IDL
D. LDL
E. Chylomicrons
195. A 65-year-old female patient has
chronic constipations due to the colon
hypotonia. What drug should be chosen
in this case?
A. Bisacodyl
B. Castor oil
C. Magnesium sulfate
D. Neostigmine methylsulfate
E. Metoclopramide
196. A female patient complains of
vision impairment. On examination
she was found to have obesity, fasting
hyperglycemia. What complication of di-
abetes can cause vision impairment?
22
A. Microangiopathy
B. Macroangiopathy
C. Atherosclerosis
D. Neuropathy
E. Glomerulopathy
197. Analysis of the family history of
children with Van der Woude syndrome
revealed that in their families one of the
parents had the typical for this syndrome
defects (cleft lip and palate, lip pits
regardless of gender). What is the type
of inheritance of this syndrome?
A. Autosomal dominant
B. X-linked recessive
C. X-linked dominant
D. Autosomal recessive
E. Multifactorial
198. Administration of doxycycline
hydrochloride caused an imbalance of the
symbiotic intestinal microflora. Specify
the kind of imbalance caused by the anti-
biotic therapy:
A. Dysbacteriosis
B. Sensibilization
C. Idiosyncrasy
D. Superimposed infection
E. Bacteriosis
199. A 3-year-old child had eaten some
strawberries. Soon he developed a rash
and itching. What was found in the child’s
leukogram?
A. Eosinophilia
B. Hypolymphemia
C. Neutrophilic leukocytosis
D. Monocytosis
E. Lymphocytosis
200. A 12-year-old patient was found to
have blood serum cholesterol at the rate
of 25 mmol/l. The boy has a history of
hereditary familial hypercholesterolemia,
which is caused by the impaired synthesis
of the following protein receptors:
A. Low density lipoproteins
B. High density lipoproteins
C. Chylomicrons
D. Very low density lipoproteins
E. Intermediate density lipoproteins
 Krok 1 Medicine 2014
1. The infectious diseases department
of a hospital admitted a patient wi-
th nausea, liquid stool with mucus
and blood streaks, fever, weakness.
Dysentery was suspected. What
method of laboratory diagnostics
should be applied to confirm the di-
agnosis?
A. Bacteriological
B. Serological
C. Mycological
D. Microscopic
E. Protozoological
2. Malaria is treated with structural
analogs of vitamin B2 (riboflavin).
These drugs disrupt the synthesis of
the following enzymes in plasmodium:
A. FAD-dependent dehydrogenase
B. Cytochrome oxidase
C. Peptidase
D. NAD-dependent dehydrogenase
E. Aminotransferase
3. A 6-year-old child with suspected
active tuberculous process underwent
the diagnostic Mantoux test. What
immunobiological preparation was
injected?
A. Tuberculin
B. BCG vaccine
C. DTP vaccine
D. Tularinum
E. Td vaccine
4. In a young man during exercise, the
minute oxygen uptake and carbon di-
oxide emission equalled to 1000 ml.
What substrates are oxidized in the
cells of his body?
A. Carbohydrates
B. Proteins
C. Fats
D. Carbohydrates and fats
E. Carbohydrates and proteins
5. A sportsman spontaneously held
breath for 40 seconds, which resulted in
an increase in heart rate and systemic
arterial pressure. Changes of these
indicators are due to activation of the
following regulatory mechanisms:
1
A. Unconditioned sympathetic reflexes
B. Unconditioned parasympathetic
reflexes
C. Conditioned sympathetic reflexes
D. Conditioned parasympathetic
reflexes
E. -
6. A 53-year-old male patient is di-
agnosed with Paget’s disease. The
concentration of oxyproline in daily
urine is sharply increased, which pri-
marily means intensified disintegration
of:
A. Collagen
B. Keratin
C. Albumin
D. Hemoglobin
E. Fibrinogen
7. A patient has hoarseness of voi-
ce. During laryngoscopy a gray-white
larynx tumor with papillary surface has
been detected. Microscopic investigati-
on has shown the following: growth of
connective tissue covered with multi-
layer, strongly keratinized pavement
epithelium, no cellular atypia. What is
the most likely diagnosis?
A. Papilloma
B. Fibroma
C. Polyp
D. Angioma
E. Angiofibroma
8. During autopsy approximately 2,0
liters of pus have been found in the
abdominal cavity of the corpse. Peri-
toneum is lustreless and has grayish
shade, serous tunic of intestines has
grayish-colored coating that is easily
removable. Specify the most likely type
of peritonitis in the patient:
A. Fibrinopurulent peritonitis
B. Hemorrhagic peritonitis
C. Serous peritonitis
D. Tuberculous peritonitis
E. -
9. Autopsy of a dead patient
revealed bone marrow hyperplasia
of tubular and flat bones (pyoid
marrow), splenomegaly (6 kg) and
hepatomegaly (5 kg), enlargement of
all lymph node groups. What disease
 Krok 1 Medicine 2014 2

are the identified changes typical for? of a pesticide components is sodium

arsenate that blocks lipoic acid. Whi-
A. Chronic myelogenous leukemia ch enzyme activity is impaired by this
B. Chronic lymphocytic leukemia pesticide?
C. Multiple myeloma
D. Polycythemia vera A. Pyruvate dehydrogenase complex
E. Hodgkin’s disease B. Microsomal oxidation
C. Methemoglobin reductase
10. Autopsy of the dead patient who D. Glutathione peroxidase
died from pulmonary edema revealed E. Glutathione reductase
a large yellow-grey nidus in the
myocardium, and a fresh thrombus in 15. Stool culture test revealed in a 6-
the coronary artery. What is the most month-old bottle-fed baby the strain of
likely diagnosis? intestinal rod-shaped bacteria of anti-
gen structure 0-111. What diagnosis
A. Myocardial infarction can be made?
B. Cardiosclerosis
C. Myocarditis A. Colienteritis
D. Amyloidosis B. Gastroenteritis
E. Cardiomyopathy C. Choleriform disease
D. Food poisoning
11. An animal experiment is aimed at E. Dysentery-like disease
studying the cardiac cycle. All the heart
valves are closed. What phase of the 16. A boy referred to a genetics clinic
cycle is characterized by this status? was found to have 1 drumstick in blood
neutrophils. The boy is likely to have
A. Isometric contraction the following syndrome:
B. Asynchronous contraction
C. Protodiastolic period A. Klinefelter’s
D. Rapid filling B. Down’s
E. Reduced filling C. Turner’s
D. Edwards’
12. Cyanide is a poison that causes E. Trisomy X
instant death of the organism. What
enzymes found in mitochondria are 17. A drycleaner’s worker has been
affected by cyanide? found to have hepatic steatosis. This
pathology can be caused by the di-
A. Cytochrome oxidase (aa3) sruption of synthesis of the following
B. Flavin enzymes substance:
C. Cytochrome 5
D. NAD+-dependent dehydrogenase A. Phosphatidylcholine
E. Cytochrome P-450 B. Tristearin
C. Urea
13. Increased HDL levels decrease the D. Phosphatidic acid
risk of atherosclerosis. What is the E. Cholic acid
mechanism of HDL anti-atherogenic
action? 18. Ascarid eggs have been detected
during stool analysis. What drug
A. They remove cholesterol from ti- should be prescribed?
ssues
B. They supply tissues with cholesterol A. Mebendazole
C. They are involved in the breakdown B. Nystatin
of cholesterol C. Chloramphenicol
D. They activate the conversion of D. Tetracycline
cholesterol to bile acids E. Furazolidone
E. They promote absorption of
cholesterol in the intestine 19. Bacteriological examination of the
urine of the patient with pyelonephri-
14. It has been found out that one tis revealed microorganisms that
 Krok 1 Medicine 2014
produced yellow-green pigment and
a characteristic odor in meat-peptone
agar. What are they called?
A. Pseudomonas
B. Escherichia
C. Proteas
D. Klebsiella
E. Azotobacter
20. Feces of a patient contain high
amount of undissociated fats and have
grayish-white color. Specify the cause
of this phenomenon:
A. Obturation of bile duct
B. Hypoactivation of pepsin by
hydrochloric acid
C. Hypovitaminosis
D. Enteritis
E. Irritation of intestinal epithelium
21. A 46-year-old female patient
consulted a doctor about pain in the
small joints of the upper and lower
limbs. The joints are enlarged and
shaped like thickened nodes. Serum
test revealed an increase in urate
concentration. This might be caused
by a disorder in metabolism of:
A. Purines
B. Carbohydrates
C. Lipids
D. Pyrimidines
E. Amino acids
22. A 26-year-old female consulted a
doctor about having stool with whi-
te flat moving organisms resembli-
ng noodles. Laboratory analysis
revealed proglottids with the followi-
ng characteristics: long, narrow, with a
longitudinal channel of the uterus wi-
th 17-35 lateral branches on each side.
What kind of intestinal parasite was
found?
A. Taeniarhynchus saginatus
B. Taenia solium
C. Hymenolepis nana
D. Diphyllobothrium latum
E. Echinococcus granulosus
23. A male patient is 28 years old. Hi-
stological study of a cervical lymph
node revealed a change of its pattern
due to the proliferation of epithelioid,
lymphoid cells and macrophages havi-
3
ng nuclei in form of a horseshoe. In
the center of some cell clusters there
were non-structured light-pink areas
with fragments of nuclei. What disease
are these changes typical for?
A. Tuberculosis
B. Hodgkin’s disease
C. Actinomycosis
D. Tumor metastasis
E. Syphilis
24. A biochemical urine analysis has
been performed for a patient with
progressive muscular dystrophy. In
the given case muscle disease can be
confirmed by the high content of the
following substance in urine:
A. Creatine
B. Porphyrin
C. Urea
D. Hippuric acid
E. Creatinine
25. While examining foot blood supply
a doctor checks the pulsation of a
large artery running in the separate
fibrous channel in front of articulatio
talocruralis between the tendons of
long extensor muscles of hallux and
toes. What artery is it?
A. A. dorsalis pedis
B. A. tibialis anterior
C. A. tarsea medialis
D. A. tarsea lateralis
E. A. fibularis
26. A patient with chronic heart fai-
lure with edema has increased level
of blood aldosterone. What diuretic
would be most effective in this case?
A. Spironolactone
B. Triamterene
C. Acetazolamide
D. Hydrochlorothiazide
E. Furosemide
27. During autopsy the following
has been revealed: the meninges
of the upper cerebral hemispheres
are extremely plethoric, of yellow-
green color and are soaked with
purulent effluent. What kind of meni-
ngitis is characterised by such clinical
presentations?
 Krok 1 Medicine 2014
A. Meningococcal meningitis
B. Tuberculous meningitis
C. Grippal meningitis
D. Anthrax-induced
E. Epidemic typhus-induced
28. A 41-year-old male patient
has a history of recurrent attacks
of heartbeats (paroxysms), profuse
sweating, headaches. Examination
revealed hypertension, hyperglycemia,
increased basal metabolic rate, and
tachycardia. These clinical presentati-
ons are typical for the following
adrenal pathology:
A. Hyperfunction of the medulla
B. Hypofunction of the medulla
C. Hyperfunction of the adrenal cortex
D. Hypofunction of the adrenal cortex
E. Primary aldosteronism
29. A comminuted fracture of
infraglenoid tubercle caused by
shoulder joint injury has been detected
during X-ray examination of a patient.
What muscle tendon attached at this
site has been damaged?
A. Long head of m. triceps brachii
B. Long head of m. biceps brachii
C. Medial head of m. triceps brachii
D. Lateral head of m. triceps brachii
E. Short head of m. biceps brachii
30. A patient has increased thickness
of alveolar-capillary membrane caused
by a pathologic process. The direct
consequence will be reduction of the
following value:
A. Diffusing lung capacity
B. Oxygen capacity of blood
C. Respiratory minute volume
D. Alveolar ventilation of lungs
E. Expiratory reserve volume
31. What drug will be most appropriate
for the patient who has chronic gastri-
tis with increased secretion?
A. Pirenzepine
B. Pancreatine
C. Pepsin
D. Aprotinin
E. Chlorphentermine
32. As a result of careless handling of
an iron, a 34-year-old female patient
4
has got acute pain, redness, swelling
of her right index finger. A few mi-
nutes later, there appeared a blister fi-
lled with a transparent liquid of straw-
yellow color. The described changes
are a manifestation of the following
pathological process:
A. Exudative inflammation
B. Traumatic edema
C. Alternative inflammation
D. Proliferative inflammation
E. Vacuolar degeneration
33. A 42-year-old male with a lesion of
the ulnar nerve is unable to flex the
II and V fingers to the midline. Whi-
ch muscle function is impaired in this
case?
A. Palmar interosseous muscles
B. Dorsal interosseous muscle
C. Fidicinales
D. Short palmar muscle
E. Abductor muscle of little finger
34. A smear from the tonsillar coating
of a patient with suspected diphtheria
was found to contain blue bacilli with a
thickening at the poles. What method
of smear staining was used?
A. Leffler
B. Burri
C. Hins
D. Gram
E. Neisser
35. A child was born asphyxiated.
What drug must be administered to the
newborn to stimulate breathing?
A. Aethimizolum
B. Lobeline
C. Prazosin
D. Atropine
E. Proserine
36. A 40-year-old patient with the
progressing staphylococcal purulent
periodontitis developed purulent
inflammation of bone marrow spaces
of the alveolar process, and then of
the body of mandible. Microscopy
revealed thinning of bone trabeculae,
foci of necrosis, bone sequesters
surrounded by the connective tissue
capsule. What is the most likely di-
agnosis?
 Krok 1 Medicine 2014
A. Chronic osteomyelitis
B. Acute osteomyelitis
C. Parodontome
D. Chronic fibrous periostitis
E. Purulent abscess
37. Human red blood cells do not
contain mitochondria. What is the
main pathway for ATP production in
these cells?
A. Anaerobic glycolysis
B. Aerobic glycolysis
C. Oxidative phosphorylation
D. Creatine kinase reaction
E. Cyclase reaction
38. A 40-year-old female patient has
undergone thyroidectomy. Histological
study of thyroid gland found the folli-
cles to be of different size and contain
foamy colloid, follicle epithelium is hi-
gh and forms papillae, there is focal
lymphocytic infiltration in stroma. Di-
agnose the thyroid gland disease:
A. Basedow’s disease
B. Hashimoto’s thyroiditis
C. Riedel’s thyroiditis
D. De Quervain’s disease
E. Nodular goiter
39. A 43-year-old-patient has arteri-
al hypertension caused by an increase
in cardiac output and general peri-
pheral resistance. Specify the variant of
hemodynamic development of arterial
hypertension in the given case:
A. Eukinetic
B. Hyperkinetic
C. Hypokinetic
D. Combined
E. -
40. A patient has been hospitalised
with provisional diagnosis of virus B
hepatitis. Serological reaction based
on complementation of antigen with
antibody chemically bound to peroxi-
dase or alkaline phosphatase has been
used for disease diagnostics. What is
the name of the applied serological
reaction?
5
A. Immune-enzyme analysis
B. Radioimmunoassay technique
C. Immunofluorescence test
D. Bordet-Gengou test
E. Antigen-binding assay
41. A patient has been hospitalised wi-
th provisional diagnosis of botulism.
What serological reaction should be
used to reveal botulinum toxin?
A. Neutralization reaction
B. Agglutination reaction
C. Bordet-Gengou test
D. Precipitation reaction
E. Immunofluorescence test
42. Examination of a 52-year-old
female patient has revealed a decrease
in the amount of red blood cells and
an increase in free hemoglobin in
the blood plasma (hemoglobinemia).
Color index is 0,85. What type of
anemia is being observed in the pati-
ent?
A. Acquired hemolytic
B. Hereditary hemolytic
C. Acute hemorrhagic
D. Chronic hemorrhagic
E. Anemia due to diminished
erythropoiesis
43. 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:
A. Heat radiation
B. Heat conduction
C. Convection
D. Evaporation
E. -
44. Urine analysis has shown high
levels of protein and erythrocytes
in urine. This can be caused by the
following:
A. Renal filter permeability
B. Effective filter pressure
C. Hydrostatic blood pressure in
glomerular capillaries
D. Hydrostatic primary urine pressure
in capsule
E. Oncotic pressure of blood plasma
45. The development of both immune
 Krok 1 Medicine 2014
and allergic reactions is based upon
the same mechanisms of the immune
system response to an antigen. What
is the main difference between the
immune and allergic reactions?
A. Development of tissue lesion
B. Amount of released antigen
C. Antigen structure
D. Routes by which antigens are deli-
vered into the body
E. Hereditary predisposition
46. After a craniocerebral injury a pati-
ent is unable to recognize objects by
touch. What part of brain has been
damaged?
A. Postcentral gyrus
B. Occipital lobe
C. Temporal lobe
D. Precentral gyrus
E. Cerebellum
47. A patient complaining of rapid
pulse, dyspnea and bluish color of
mucosa has been admitted to the cardi-
ological department. The objective
symptoms are as follows: edema of
lower extremities, ascites. Which of
the given medicines should be prescri-
bed for intravenous administration to
improve the patient’s general state?
A. Corglyconum
B. Cordiamin
C. Adrenalin hydrochloride
D. Digitoxin
E. Drotaverine
48. As a result of a continuous
chronic encephalopathy, a patient has
developed spontaneous motions and
a disorder of torso muscle tone. These
are the symptoms of the disorder of the
following conduction tract:
A. Tractus rubrospinalis
B. Tractus corticospinalis
C. Tractus corticonuclearis
D. Tractus spinothalamicus
E. Tractus tectospinalis
49. A 10-year-old child has painful
swallowing, neck edema, temperature
rise up to 39, 0oC , the whole body
is covered with bright-red petechial
rash. Back of the throat and tonsils
are hyperemic, the tongue is crimson-
6
colored. Tonsillar surface is covered
with isolated grayish-colored necrosis
nidi. What disease is it?
A. Scarlet fever
B. Meningococcal nasopharyngitis
C. Diphtheria
D. Influenza
E. Measles
50. In a patient elevation of body
temperature takes turns with drops
down to normal levels during the day.
The rise in temperature is observed
periodically once in four days. Speci-
fy the type of temperature curve:
A. Febris internuttens
B. Febris continua
C. Febris reccurens
D. Febris hectica
E. Febris remitens
51. As a result of a craniocerebral
injury, a patient has a decreased skin
sensitivity. What area of the cerebral
cortex is likely to be damaged?
A. Posterior central gyrus
B. Occipital region
C. Cingulate gyrus
D. Frontal cortex
E. Anterior central gyrus
52. 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 fai-
lure development is most likely in the
case of this patient?
A. Reduction of active nephron mass
B. Decrease in systemic arterial
pressure
C. Obstruction of nephron tubules with
hyaline casts
D. Tissue acidosis
E. Arteriolar spasm
53. A 40-year-old patient has ulcer
perforation in the posterior wall of
stomach. What anatomical structure
will blood and stomach content leak
to?
 Krok 1 Medicine 2014
A. Bursa omentalis
B. Bursa praegastrica
C. Right lateral channel (canalis
lateralis dexter)
D. Left lateral channel (canalis lateralis
sinister)
E. Bursa hepatica
54. A patient is diagnosed with heredi-
tary coagulopathy that is characterised
by factor VIII deficiency. Specify the
phase of blood clotting during which
coagulation will be disrupted in the gi-
ven case:
A. Thromboplastin formation
B. Thrombin formation
C. Fibrin formation
D. Clot retraction
E. -
55. Angiocardiography of a 60-year-
old male patient revealed constri-
ction of a vessel located in the left
coronary sulcus of the heart. What is
the pathological vessel called?
A. Ramus circumflexus
B. Ramus interventricularis posterior
C. A. coronaria dextra
D. V.cordis parva
E. Ramus interventricularis anterior
56. Those organisms which in the
process of evolution failed to develop
protection from H2 O2 can exist only
in anaerobic conditions. Which of the
following enzymes can break hydrogen
peroxide down?
A. Peroxidase and catalase
B. Oxygenase and hydroxylase
C. Cytochrome oxidase, cytochrome B5
D. Oxygenase and catalase
E. Flavin-dependent oxidase
57. A patient complains of pain in
the right lateral abdomen. Palpation
revealed a dense, immobile, tumor-
like formation. A tumor is likely to be
found in the following part of the di-
gestive tube:
A. Colon ascendens
B. Colon transversum
C. Colon descendens
D. Colon sigmoideum
E. Caecum
7
58. A patient complaining of pain in
the left shoulder-blade region has been
diagnosed with miocardial infarction.
What kind of pain does the patient
have?
A. Radiating
B. Visceral
C. Phantom
D. Protopathic
E. Epicritic
59. A patient has a critical impairment
of protein, fat and hydrocarbon digesti-
on. Most likely it has been caused by
low secretion of the following digesti-
ve juice:
A. Pancreatic juice
B. Saliva
C. Gastric juice
D. Bile
E. Intestinal juice
60. A female patient has facial neuritis
that has caused mimetic paralysis and
hearing impairment. Hearing impai-
rment results from the paralysis of the
following muscle:
A. Stapedius muscle
B. Anterior auricular muscle
C. Superior auricular muscle
D. Posterior auricular muscle
E. Nasal muscle
61. A 22-year-old female student
consulted a physician about fever up to
38o C , weakness, sore throat. Objecti-
vely: there is white coating of the
tongue. What histological structures of
the tongue are involved in the formati-
on of this coating?
A. Epithelium of the filiform papillae
B. Epithelium of the foliate papillae
C. Epithelium of the fungiform papillae
D. Epithelium of the circumvallate
papillae
E. Connective-tissue base of all the
lingual papillae
62. A patient has a traumatic injury of
sternocleidomastoid muscle. This has
resulted in a decrease in the following
value:
 Krok 1 Medicine 2014
A. Inspiratory reserve volume
B. Expiratory reserve volume
C. Respiratory volume
D. Residual volume
E. Functional residual lung capacity
63. The receptors under study provide
transfer of information to the cortex
without thalamic involvement. Specify
these receptors:
A. Olfactory
B. Tactile
C. Gustatory
D. Visual
E. Auditory
64. Prolonged fasting causes
hypoglycemia which is amplified by
alcohol consumption, as the followi-
ng process is inhibited:
A. Gluconeogenesis
B. Glycolysis
C. Glycogenolysis
D. Lipolysis
E. Proteolysis
65. A 39-year-old female patient wi-
th a history of diabetes was hospitali-
zed in a precomatose state for diabetic
ketoacidosis. This condition had been
caused by an increase in the following
metabolite level:
A. Acetoacetate
B. Citrate
C. Alpha-ketoglutarate
D. Malonate
E. Aspartate
66. A 37-year-old female patient
complains of headache, vertigo,
troubled sleep, numbness of limbs. For
the last 6 years she has been working
at the gas-discharge lamp-producing
factory in the lead-processing shop.
Blood test findings: low hemoglobin
and RBC level, serum iron concentrati-
on exceeds the norm by several times.
Specify the type of anemia:
A. Iron refractory anemia
B. Iron-deficiency anemia
C. Minkowsky-Shauffard disease
D. Hypoplastic anemia
E. Metaplastic anemia
67. During an animal experiment,
8
surgical damage of certain brain
structures has caused deep prolonged
sleep. What structure is most likely to
cause such condition, if damaged?
A. Reticular formation
B. Basal ganglion
C. Red nuclei
D. Hippocampus
E. Cerebral cortex
68. A patient takes cholagogues. What
other process besides biliary excretion
will be stimulated?
A. Intestinal motility
B. Gastric juice secretion
C. Pancreatic juice secretion
D. Gastric motor activity
E. Water absorption
69. A 3-year-old child with meni-
ngeal symptoms died. Postmortem
macroscopy of the pia matter revealed
miliary nodules which were mi-
croscopically represented by a focus
of caseous necrosis with masses of epi-
thelioid and lymphoid cells with some
crescent-shaped large cells inbetween
having peripheral nuclei. Specify the
type of meningitis in the child:
A. Tuberculous
B. Syphilitic
C. Brucellar
D. Grippal
E. Meningococcal
70. A patient with homogentisuria has
signs of arthritis, ochronosis. In this
case, the pain in the joints is associ-
ated with the deposition of:
A. Homogentisates
B. Urates
C. Phosphates
D. Oxalates
E. Carbonates
71. A patient with hereditary
hyperammonemia due to a disorder
of ornithine cycle has developed
secondary orotaciduria. The increased
synthesis of orotic acid is caused by an
increase in the following metabolite of
ornithine cycle:
 Krok 1 Medicine 2014
A. Carbamoyl phosphate
B. Citrulline
C. Ornithine
D. Urea
E. Argininosuccinate
72. Amniocentesis revealed two sex
chromatin bodies (Barr bodies) in each
cell of the sample. What disease is this
character typical for?
A. Trisomy X
B. Klinefelter syndrome
C. Turner’s syndrome
D. Down’s syndrome
E. Patau syndrome
73. A 49-year-old male patient wi-
th acute pancreatitis was likely to
develop pancreatic necrosis, while acti-
ve pancreatic proteases were absorbed
into the blood stream and tissue protei-
ns broke up. What protective factors of
the body can inhibit these processes?
A. α2 -macroglobulin, α1 -antitrypsin
B. Immunoglobulin
C. Cryoglobulin, interferon
D. Ceruloplasmin, transferrin
E. Hemoplexin, haptoglobin
74. A 16-year-old female patient has
fainted after quickly changing her body
position from horizontal to vertical
one. Which process from the ones
listed below has caused the loss of
consciousness in the first place?
A. Decreasing venous return
B. Increasing venous return
C. Increasing central venous pressure
D. Decreasing oncotic pressure of blood
plasma
E. Increasing arterial pressure
75. A 53-year-old male patient
complains of acute pain in the right
hypochondrium. Objective examinati-
on revealed scleral icterus. Laboratory
tests revealed increased ALT activity,
and stercobilin was not detected in the
stool. What disease is characterized by
these symptoms?
9
A. Cholelithiasis
B. Hemolytic jaundice
C. Hepatitis
D. Chronic colitis
E. Chronic gastritis
76. A child patient has dry cough. What
non-narcotic antitussive drug will reli-
eve the patient’s condition?
A. Glaucine hydrochloride
B. Codeine phosphate
C. Morphine hydrochloride
D. Potassium iodide
E. Althaea officinalis root extract
77. A patient complains of acute pain
attacks in the right lumbar region.
During examination the nephrolithic
obturation of the right ureter in the
region between its abdominal and
pelvic segments has been detected.
What anatomical boundary exists
between those two segments?
A. Linea terminalis
B. Linea semilunaris
C. Linea arcuata
D. Linea transversa
E. Linea inguinalis
78. When measuring total muscle acti-
on potential it was revealed that it was
subject to the power-law relationship.
The reason for this is that individual
muscle fibers differ in:
A. Depolarization threshold
B. Diameter
C. Conduction velocity
D. Resting potential
E. Critical level of depolarization
79. 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:
A. Angiotensin II
B. Angiotensinogen
C. Renin
D. Catecholamines
E. Norepinephrine
80. A patient is diagnosed with iron-
deficiency sideroachrestic anemia,
 Krok 1 Medicine 2014
progression of which is characteri-
sed by skin hyperpigmentation, pi-
gmentary cirrhosis, heart and pancreas
affection. Iron level in the blood serum
is increased. What disorder of iron
metabolism causes this disease?
A. Failure to assimilate iron leading to
iron accumulation in tissues
B. Excessive iron intake with food
C. Disorder of iron absorption in
bowels
D. Increased iron assimilation by body
E. -
81. In a village, a case of anthrax
had been registered. Medical servi-
ces began epidemiologically indicated
specific prophylaxis of population agai-
nst anthrax. What preparation was
used for this purpose?
A. Live vaccine
B. Inactivated vaccine
C. Chemical vaccine
D. Genetically engineered vaccine
E. Anatoxin
82. Experimental stimulation of the
sympathetic nerve branches that
innervate the heart caused an increase
in force of heart contractions because
the membrane of typical cardi-
omyocytes permitted an increase in:
A. Calcium ion entry
B. Calcium ion exit
C. Potassium ion exit
D. Potassium ion entry
E. Calcium and potassium ion exit
83. According to the results of glucose
tolerance test, the patient has no
disorder of carbohydrate tolerance.
Despite that, glucose is detected in
the patients’s urine (5 mmol/l). The
patient has been diagnosed with renal
diabetes. What renal changes cause
glucosuria in this case?
A. Decreased activity of glucose
reabsorption enzymes
B. Increased activity of glucose
reabsorption enzymes
C. Exceeded glucose reabsorption
threshold
D. Increased glucose secretion
E. Increased glucose filtration
10
84. As a result of past encephalitis, a
male patient has developed an increase
in cerebrospinal fluid pressure in the
right lateral ventricle. What can be the
cause of this condition?
A. Closure of right interventricular
foramen
B. Closure of left interventricular
foramen
C. Atresia of tubus medullaris
D. Atresia of sylvian aqueduct
E. Atresia of the fourth ventricle
foramina
85. Parents of 5-year-old child report
him o have frequent colds that develop
into pneumonias, presence of purulent
rashes on the skin. Laboratory tests
have revealed the following: absence
of immunoglobulins of any type, and
naked cells are absent from the lymph
nodes punctate. What kind of immune
disorder is it?
A. X-linked hypogammaglobulinemia
(Bruton type agammaglobulinemia)
B. Autosomal recessive
agammaglobulinaemia (Swiss type)
C. Hypoplastic anemia
D. Agranulocytosis
E. Louis-Barr syndrome
86. A 3-year-old child has conti-
nuous 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?
A. Infectious mononucleosis
B. Burkitt’s lymphoma
C. Herpetic lymphadenopathy
D. Generalized infection caused by
herpes-zoster
E. Cytomegalovirus infection
87. A microslide contains the preparati-
on of a gland composed of several
secretory saccule-shaped parts that
open in the common excretory duct.
What gland is it?
 Krok 1 Medicine 2014
A. Simple branched alveolar gland
B. Compound branched alveolar gland
C. Simple unbranched alveolar gland
D. Compound unbranched alveolar
gland
E. Simple branched tubular gland
88. A patient intending to undergo
a gender reassignment surgery has
been admitted to a specialised cli-
nic. In the course of examination
both male and female gonades have
been revealed, with male structure of
external genitals. What kind of genital
maldevelopment has the patient?
A. True hermaphroditism
B. Male pseudohermaphroditism
C. Female pseudohermaphroditism
D. Accessory ovary
E. Ectopia of testis
89. An 18-year-old male has
been diagnosed with Marfan
syndrome. Examination revealed a
developmental disorder of connecti-
ve tissue and eye lens structure,
abnormalities of the cardiovascular
system, arachnodactylia. What
genetic phenomenon has caused the
development of this disease?
A. Pleiotropy
B. Complementarity
C. Codominance
D. Multiple allelism
E. Incomplete dominance
90. In case of alkaptonuria, homogenti-
sic acid is excreted in urine in large
amounts. The development of this di-
sease is associated with a disorder of
metabolism of the following amino
acid:
A. Tyrosine
B. Phenylalanine
C. Alanine
D. Methionine
E. Asparagine
91. A male patient complains of skin
insensitivity of inferior eyelid, external
lateral surface of nose and upper lip.
A doctor in the course of examinati-
on has revealed inflammation of the
second branch of trigeminal nerve.
What cranial foramen does this branch
11
go through?
A. Supraorbital
B. Lacerum
C. Superior orbital fissure
D. Spinosum
E. Oval
92. An patient with insomnia induced
by allergic rash and itch has been
prescribed the drug that has antihi-
stamine and hypnotic effect. Specify
this drug:
A. Benadryl
B. Loratadine
C. Prednisolone
D. Acetylsalicylic acid
E. Analgin
93. In a cat with decerebrate rigidity
the muscle tone is to be decreased. This
can be achieved by:
A. Destruction of the vestibular nuclei
of Deiters
B. Stimulation of the otolithic vesti-
bular receptors
C. Stimulation of the vestibular nuclei
of Deiters
D. Stimulation of the vestibulocochlear
nerve
E. Stimulation of the ampullar vesti-
bular receptors
94. When studying the signs of
pulmonary ventilation, reduction of
forced expiratory volume has been
detected. What is the likely causeof this
phenomenon?
A. Obstructive pulmonary disease
B. Increase of respiratory volume
C. Increase of inspiratory reserve
volume
D. Increase of pulmonary residual
volume
E. Increase of functional residual lung
capacity
95. X-ray examination of a patient
allowed to diagnose a tumor in the
superior lobe of the right lung. There
is a probability of metastases spread to
the following lymph nodes:
 Krok 1 Medicine 2014
A. Sternal
B. Inferior mediastinum
C. Anterior mediastinum
D. Axillary
E. Deep lateral cervical
96. A 55-year-old patient with a
characteristic rash, fever, dizziness
has been admitted to a hospital. He
has been provisionally diagnosed wi-
th typhus. No similar cases have been
reported. In his youth (15 years old)
the patient suffered typhus in a boardi-
ng school. What disease is it?
A. Brill’s disease
B. Typhoid fever
C. Measles
D. Rubella
E. Cholera
97. A young woman suddenly
developed fever up to 39o C accompani-
ed by a strong headache. Examinati-
on revealed marked nuchal rigidi-
ty. Spinal puncture was performed.
Gram-stained smear of cerebrospi-
nal fluid contained many neutrophi-
ls and Gram-positive diplococci. What
bacteria could be the cause of this di-
sease?
A. Neisseria meningitidis
B. Streptococcus pneumonia
C. Haemophilus influenzae
D. Staphylococcus aureus
E. Pseudomonas aeruginosa
98. 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:
A. Tropic hormones
B. Thyroid hormones
C. Somatotropin
D. Cortisol
E. Thyroxin
99. Degenerative changes in posteri-
or and lateral columns of spinal
cord (funicular myelosis) caused by
methylmalonic acid accumulation
occur in patients with B12 -deficiency
anemia. This results in synthesis di-
sruption of the following substance:
12
A. Myelin
B. Acetylcholine
C. Norepinephrine
D. Dopamine
E. Serotonin
100. A patient with suspected tumor
of lung had been admitted to the
oncological department. Examinati-
on revealed localised pathology in the
inferior lobe of the left lung. How
many bronchopulmonary segments
does this lobe have?
A. 5
B. 6
C. 4
D. 3
E. 2
101. During local anesthetization the
patient has gone into anaphylactic
shock. What drug must be admini-
stered to the patient?
A. Epinephrine hydrochloride
B. Diazepam
C. Atropine sulfate
D. Propranolol
E. Nitroglycerin
102. As a result of an injury, the integri-
ty of the anterior spinal cord root was
broken. Specify the neurons and their
processes that had been damaged:
A. Axons of motor neurons
B. Motor neuron dendrites
C. Axons of sensory neurons
D. Dendrites of sensory neurons
E. Dendrites of association neurons
103. A patient who had been taking di-
clofenac sodium for arthritis of mandi-
bular joint developed an acute conditi-
on of gastric ulcer. Such side effect of
this medicine is caused by inhibition of
the following enzyme:
A. Cyclooxygenase-1 (COX-1)
B. Cyclooxygenase-2 (COX-2)
C. Lipoxygenase
D. Phosphodiesterase
E. Monoamine oxidase
104. In one of Polessye regions there
was an outbreak of helminthiasis mani-
fested by cramps and facial edmata.
 Krok 1 Medicine 2014
The developed preventive measures
in particular included ban for eating
infested pork even after heat processi-
ng. What helminthiasis was the case?
A. Trichinosis
B. Taeniarhynchosis
C. Teniasis
D. Echinococcosis
E. Alveococcosis
105. A female patient saught medical-
genetic consultation. Physical exami-
nation revealed pterygium colli
deformity (webbed neck), broad chest,
underdeveloped breasts. Study of
buccal epithelium cells revealed no
X-chromatin in the nuclei. This indi-
cates that the patient has the following
syndrome:
A. Turner’s
B. Klinefelter’s
C. Patau’s
D. Down’s
E. Edwards’
106. During blood transfusion a
patient has developed intravascular
erythrocyte hemolysis. What kind of
hypersensitivity does the patient have?
A. II type (antibody-dependent)
B. I type (anaphylactic)
C. III type (immune complex)
D. IV type (cellular cytotoxicity)
E. IV type (granulomatosis)
107. 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?
A. Uroporphyrinogen III cosynthase
B. Uroporphyrinogen I synthase
C. Delta-aminolevulinate synthase
D. Uroporphyrinogen decarboxylase
E. Ferrochelatase
108. During the air and bone conducti-
on tests it was revealed that in the
left ear the tones were louder by bone
conduction. This might be associated
with the disease of:
13
A. Left middle ear
B. Right middle ear
C. Left inner ear
D. Right inner ear
E. Right external ear
109. In course of invasive abdominal
surgery a surgeon has to locate the ori-
gin of the mesenteric root. Where is it
normally localized?
A. Duodenojejunal flexure
B. Right flexure of colon
C. Left flexure of colon
D. Sigmoid colon
E. Right mesenteric sinus
110. A 55-year-old male had been
delivered to the resuscitation unit
unconscious. Relatives reported him
to have mistakenly drunk an alcoholic
solution of unknown origin. On exami-
nation the patient was diagnosed with
methanol intoxication. What antidote
should be used in this case?
A. Ethanol
B. Teturamum
C. Naloxone
D. Protamine sulfate
E. Acetylcysteine
111. Due to the use of poor-
quality measles vaccine for preventi-
ve vaccination, a 1-year-old chi-
ld has developed an autoimmune
renal injury. The urine was found
to contain macromolecular proteins.
What process of urine formation has
been disturbed?
A. Filtration
B. Reabsorption
C. Secretion
D. Reabsorption and secretion
E. Secretion and filtration
112. As a result of a road accident a 37-
year-old female victim developed uri-
nary incontinence. What segments of
the spinal cord had been damaged?
A. S2 − S4
B. T h1 − T h5
C. L1 − L2
D. T h2 − T h5
E. T h1 − L1
113. An 8-week-pregnant woman
 Krok 1 Medicine 2014
with acute respiratory disease and
temperature rise up to 39, 0oC has
called in a doctor. The doctor insisted
on her avoiding taking paracetamol,
because in this period of pregnancy
there is a risk of its:
A. Teratogenicity
B. Embryotoxicity
C. Fetotoxicity
D. Hepatotoxicity
E. Allergenicity
114. A pneumonia patient has been
administered acetylcysteine as a part
of complex therapy. What principle
of therapy has been taken into consi-
deration when applying this drug?
A. Pathogenetic
B. Symptomatic
C. Etiotropic
D. Antimicrobial
E. Immunomodulatory
115. A 26-year-old female patient wi-
th bronchitis has been administered a
broad spectrum antibiotic as a causal
treatment drug. Specify this drug:
A. Doxycycline
B. Interferon
C. BCG vaccine
D. Ambroxol
E. Dexamethasone
116. When defining blood group
according to the AB0 system, using
salt solutions of monoclonal antibodi-
es, agglutination didn’t occur with any
of the solutions. What blood group is
it?
A. 0 (I)
B. А (II)
C. В (III)
D. АВ (IV)
E. -
117. Examination of a 56-year-old
female patient with a history of type
1 diabetes revealed a disorder of
protein metabolism that is manifested
by aminoacidemia in the laboratory
blood test values, and clinically by the
delayed wound healing and decreased
synthesis of antibodies. Which of
the following mechanisms causes the
14
development of aminoacidemia?
A. Increased proteolysis
B. Albuminosis
C. Decrease in the concentration of
amino acids in blood
D. Increase in the oncotic pressure in
the blood plasma
E. Increase in low-density lipoprotein
level
118. 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:
A. Tryptophan
B. Threonine
C. Arginine
D. Histidine
E. Lysine
119. A 68-year-old patient consults
a cardiologist, complaining of high
arterial blood pressure, pain in the
heart egion, intermittent pulse. Prescri-
be the β1 -adrenoreceptor blocker
for the treatment of the described
pathology:
A. Metoprolol
B. Morphine hydrochloride
C. Nootropil
D. Fenoterol
E. Benzylpenicillin
120. A female suffered rubella duri-
ng pregnancy. The child was born
with developmental abnormalities,
namely cleft lip and palate. The child’s
genotype is normal. These malformati-
ons are a manifestation of:
A. Modification variability
B. Polyploidy
C. Combinative variability
D. Chromosomal mutation
E. Aneuploidy
121. An electron micrograph shows
a cell-to-cell adhesion consisting, in
each cell, of an attachment plaque.
The intercellular space is filled wi-
th electron-dense substance includi-
ng transmembrane fibrillar structures.
Specify this adhesion:
 Krok 1 Medicine 2014
A. Desmosome
B. Synapse
C. Tight junction
D. Nexus
E. Adherens junction
122. 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?
A. Creatine kinase isoenzyme CK-MB
B. Creatine kinase isoenzyme CK-MM
C. LDH1 lactate dehydrogenase
isoenzyme
D. LDH2 lactate dehydrogenase
isoenzyme
E. Aspartate aminotransferase
cytoplasmic isoenzyme
123. A patient complains of pain in
the heart area during acute attack of
gastric ulcer. What vegetative reflex
can cause this painful feeling?
A. Viscerovisceral reflex
B. Viscerodermal reflex
C. Visceromotor reflex
D. Dermatovisceral reflex
E. Motor-visceral reflex
124. A patient is diagnosed with acute
morphine hydrochloride intoxication.
Prescribe an oxidizing agent for gastric
lavage:
A. Potassium permanganate
B. Chloramine
C. Sulfocamphocainum (Procaine +
Sulfocamphoric acid)
D. Cerigel
E. Chlorhexidine (bi)gluconate
125. In the course of puncture biopsy
of transplanted kidney the followi-
ng has been revealed: diffuse infi-
ltration of stroma by lymphocytes
and plasmocytes and necrotic arteri-
tis. What pathological process has
developed in the transplant?
15
A. Immune rejection
B. Ischemic kidney failure
C. Glomerulonephritis
D. Tubular necrosis
E. Pyelonephritis
126. During cell division, DNA repli-
cation occurs by a signal from the
cytoplasm, and a certain portion of the
DNA helix unwinds and splits into two
individual strains. What enzyme facili-
tates this process?
A. Helicase
B. RNA polymerase
C. Ligase
D. Restrictase
E. DNA polymerase
127. A female patient, having visited
the factory premises with lots of dust in
the air for the first time, has got cough
and burning pain in the throat. What
respiratory receptors, when irritated,
cause this kind of reaction?
A. Irritant receptors
B. Juxtacapillary (J) receptors
C. Stretch receptors of lungs
D. Proprioceptors of respiratory
muscles
E. Thermoreceptors
128. Since a patient has had myocardi-
al infarction, his atria and ventri-
cles 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:
A. Complete atrioventricular
B. Partial atrioventricular
C. Sino-atrial
D. Intra-atrial
E. Intraventricular
129. A 35-year-old female patient has
been hospitalised with acute intoxi-
cation caused by salts of high-density
metals (lead, most probably). As a part
of complex therapy the antidote that
contains two active sulfhydric groups
has been prescribed. Specify this anti-
dote:
 Krok 1 Medicine 2014 16

A. Dimercaprol hemorrhages. Blood coagulation tests

B. Metamizole reveal increased prothrombin time.
C. Mannitol The child is most likely to have a di-
D. Nalorphine hydrochloride sorder of the following biochemical
E. Calcium chloride process:
130. A 60-year-old male patient has A. Production of gamma-
type II diabetes. A doctor has prescri- carboxyglutamate
bed him synthetic hypoglycemic long- B. Conversion of homocysteine to
acting drug that is sulfonylurea deri- methionine
vative. What drug is it? C. Conversion of methylmalonyl CoA
to succinyl CoA
A. Glibenclamide D. Degradation of glutathione
B. Butamide E. Hydroxylation of proline
C. Metformin
D. Actrapid (soluble insulin) 135. A 63-year-old male patient with
E. Acarbose bladder atony had been prescribed a
medication, which he had been arbi-
131. A patient has been given atropi- trarily taking at a higher dose. The
ne sulfate for rapid relief of spastic patient developed hypehydration, sali-
colon symptoms. The use of this drug vation, diarrhea, muscle spasms. The
is contraindicated during the followng prescribed drug relates to the followi-
disease: ng group:
A. Glaucoma A. Cholinomimetics
B. Bronchial asthma B. Cholinesterase reactivators
C. Bradycardia C. Adrenergc blockers
D. Hypotension D. Tocolytics
E. Gastric ulcer E. Ganglionic blockers
132. As an example of specific human 136. A 67-year-old male patient
parasites one can name Plasmodium consumes eggs, pork fat, butter, mi-
falciparum, human pinworm and some lk and meat. Blood test results:
others. The source of parasite invasion cholesterol - 12,3 mmol/l, total lipi-
is always a human. Such specific human ds - 8,2 g/l, increased low-density li-
parasites cause the diseases that are poprotein fraction (LDL). What type
called: of hyperlipoproteinemia is observed in
A. Anthroponoses the patient?
B. Zoonoses A. Hyperlipoproteinemia type IIa
C. Anthropozoonoses B. Hyperlipoproteinemia type I
D. Infections C. Hyperlipoproteinemia type IIb
E. Multifactorial diseases D. Hyperlipoproteinemia type IV
133. In an experiment a dog had been E. Cholesterol, hyperlipoproteinemia
conditioned to salivate at the sight of 137. Tissue sampling of a 37-year-old
food and a flash of light. After conditi- male patient with chronic renal disease
oning the reflex, the light was then pai- has revealed the following: sclerosis,
red with the bell. The dog didn’t start lymphocytic and plasmocytic infiltrati-
to salivate. What type of inhibition was on of renal pelvis and calices walls,
observed? dystrophy and atrophy of tubules.
A. External Remaining tubules are enlarged and
B. Differential stretched with colloid masses, epitheli-
C. Extinctive um is flattened out ("scutiform"or
D. Persistent "shield-shaped"kidney). What is the
E. Protective most likely diagnosis?

134. A newborn baby has numerous

 Krok 1 Medicine 2014
A. Chronic pyelonephritis
B. Tubular interstitial nephritis
C. Acute pyelonephritis
D. Glomerulonephritis
E. Nephrosclerosis
138. During the hystological study
of cortical shaft, basophilic cells wi-
th developed synthesis organelles can
be seen on the bone surface under the
layer of fibers. These cells take part in
bone tissue regeneration. What shaft
layer are they located in?
A. Periosteum
B. Bone
C. Osteon layer
D. Outer lamellae of compact bone
tissue
E. Inner lamellae of compact bone
tissue
139. Autopsy of a 50-year-old male
who had tuberculosis revealed a dense
gray-white nidus in form of a nodule
2 cm in diameter in the subpleural
portion of the upper right lobe. The
pleura in this region was thickened,
in the pleural cavity there was a
small amount of serous hemorrhagic
fluid. Histological study of the region
revealed some glandular structures wi-
th signs of cellular atypia and abnormal
mitoses, which were found within the
fibrous connective tissue. What other
pathology had developed in the lungs?
A. Adenocarcinoma
B. Squamous cell carcinoma
C. Adenoma
D. Fibrosarcoma
E. Fibroma
140. In course of an experiment
there has been an increase in the
nerve conduction velocity. This may
be caused by an increase in the
concentration of the following ions
that are present in the solution around
the cell:
A. Na+
B. K + and Cl−
C. K + and Na+
D. Ca2+ and Cl−
E. Ca2+
141. Hepatitis B is diagnosed through
17
laboratory tests that determine the
presence of HBA-DNA in blood serum
of the patient. What reference method
is applied for this purpose?
A. Polymerase chain reaction
B. Hybridization method
C. Hybridization signal amplification
method
D. Ligase chain reaction method
E. ELISA diagnostic method
142. On the 24th day since the onset
of disease, a male patient diagnosed
with typhoid fever and undergoing
treatment in an infectious diseases
hospital has suddenly developed cli-
nical presentations of acute abdomen
leading to the death of the patient.
During autopsy peritonitis has been
revealed, with numerous ulcers coveri-
ng the colon mucosa and reaching as
deep as muscular and, in places, serous
tunic. The ulcers have smooth edges
and even floor. The intestinal wall
is perforated. What stage of typhoid
fever has the lethal complication ari-
sen at?
A. Clean ulcer
B. Medullary swelling
C. Necrosis
D. Dirty ulcer
E. Regeneration
143. An HIV-positive patient’s cause
of death is acute pulmonary insuffi-
ciency resulting from pneumonia.
Pathohistological investigation of lungs
has revealed interstitial pneumonia,
alveolocyte desquamation and
their methamorphoses: alveolocyte
enlargement, large intranuclear
inclusions surrounded by lightly-
colored areas. Transformed cells
resemble owl’s eye. Name the
pneumonia causative agent:
A. Cytomegalovirus
B. Pneumococcus
C. Influenza virus
D. Candida fungi
E. Toxoplasma
144. The organisms to be identifi-
ed have a nucleus surrounded by a
nuclear membrane. Genetic material
is concentrated predominantly in the
 Krok 1 Medicine 2014
chromosomes which consist of DNA
strands and protein molecules. These
cells divide mitotically. Identify these
organisms:
A. Eukaryotes
B. Bacteriophages
C. Prokaryotes
D. Viruses
E. Bacteria
145. A 37-year-old male patient
developed pseudoarthrosis after a
closed fracture of the femur. Specify
the type of regeneration in the patient:
A. Pathological hypo-regeneration
B. Pathological hyper-regeneration
C. Reparative
D. Physiological
E. -
146. Nucleolar organizers of the 13-15,
21, 22 human chromosomes contain
about 200 cluster genes that synthesize
RNA. These regions of chromosomes
bear the information on the following
type of RNA:
A. rRNA
B. tRNA
C. mRNA
D. snRNA
E. tRNA + rRNA
147. The resuscitation unit has admi-
tted a patient in grave condition.
It is known that he had mistakenly
taken sodium fluoride which blocks
cytochrome oxidase. What type of
hypoxia developed in the patient?
A. Tissue
B. Hemic
C. Cardiovascular
D. Hypoxic
E. Respiratory
148. Steatosis is caused by the
accumulation of triacylglycerols in
hepatocytes. One of the mechani-
sms of this disease development is a
decrease in the utilization of VLDL
neutral fat. What lipotropics prevent
the development of steatosis?
18
A. Methionine, B6 , B12
B. Arginine, B2 , B3
C. Alanine, B1 , P P
D. Valine, B3 , B2
E. Isoleucine, B1 , B2
149. A 2-year-old boy is diagnosed with
Down syndrome. What chromosomal
changes may be the cause of this di-
sease?
A. Trisomy 21
B. Trisomy 13
C. Trisomy X
D. Trisomy 18
E. Monosomy X
150. A patient who has recently arri-
ved from an endemic area presents
with elevated body temperature,
headache, chills, malaise, that is with
the symptoms which are typical for a
common cold. What laboratory tests
are necessary to prove or to disprove
the diagnosis of malaria?
A. Microscopy of blood smears
B. Study of lymph node punctate
C. Urinalysis
D. Study of cerebrospinal fluid
E. Microscopy of bone marrow
punctate
151. A patient has severe blood loss
caused by an injury. What kind of
dehydration will be observed in this
particular case?
A. Iso-osmolar
B. Hyposmolar
C. Hyperosmolar
D. Normosmolar
E. -
152. A 30-year-old patient has dyspnea
fits, mostly at night. He has been di-
agnosed with bronchial asthma. What
type of allergic reaction according to
the Gell-Coombs classification is most
likely in this case?
A. Anaphylactic
B. Cytotoxic
C. Stimulating
D. Immune complex
E. Delayed-type hypersensitivity
153. Decarboxylation of glutamate
induces production of gamma-
 Krok 1 Medicine 2014
aminobutyric acid (GABA ) nned substance. Microscopic investi-
neurotransmitter. After breakdown,
GABA is converted into a metaboli-
te of the citric acid cycle, that is:
A. Succinate
B. Citric acid
C. Malate
D. Fumarate
E. Oxaloacetate
154. An outbreak of an intestinal
infection occurred in a kindergarten on
the eve of New Year holidays. Bacteri-
ological examination of patients’
faeces didn’t reveal any pathogenic
bacteria. Electron microscopy revealed
roundish structures with clear outer
edges and a thick core resembling a
wheel. Specify the most likely causati-
ve agent of this infection:
A. Rotavirus
B. Adenovirus
C. Coxsacki-virus
D. E.coli
E. P.vulgaris
155. A smear of streptobacillus
preparation stained by Ozheshko
method has been studied microscopi-
cally with oil immersion. What
structural feature of the bacteria has
been studied?
A. Spores
B. Capsule
C. Flagella
D. Inclusions
E. Structure of cell wall
156. After a road accident a victim
has tachycardia, arterial blood pressure
130/90 mm Hg, tachypnoe, the skin
is pale and dry, excitation of central
nervous system is observed. What
shock stage is the patient most likely
in?
A. Erectile
B. Terminal
C. Torpid
D. Preshock (compensation stage)
E. Agony
157. Autopsy has revealed shrunken
kidneys weighing 50 mg, with fine-
grained surface and uniformly thi-
19
gation has shown the thickening of
arteriole walls due to accumulation of
homogeneous anhistic pink-coloured
masses in them. Glomerules were
undersized, sclerotic, with atrophi-
ed tubules. What disease are these
changes characteristic of?
A. Essential hypertension
B. Pyelonephritis with kidney shrinkage
C. Renal amyloidosis
D. Acute glomerulonephritis
E. Membranous nephropathy
158. A fixed-run taxi passenger has
a sudden and expressed attack of
tachycardia. A doctor travelling by the
same taxi has managed to slow down
his heart rate by pressing upon the
eyeballs and thus causing the following
reflex:
A. Dagnini-Aschner reflex
B. Bainbridge reflex
C. Holtz’s reflex
D. Hering-Breuer reflex
E. Frank-Starling mechanism
159. Histological examination of bi-
opsy samples taken from the thickened
edges of a gastric ulcer revealed small
clusters of small, markedly atypical
hyperchromatic epithelial cells that
were localized in the overdeveloped
stroma. Specify the tumor:
A. Scirrhous undifferentiated carci-
noma
B. Medullary carcinoma
C. Adenocarcinoma
D. Undifferentiated sarcoma
E. Adenoma
160. A 10-year-old child was found to
have a congenital hypoplasia of the
left kidney. Ultrasound examination
revealed that the right kidney was
markedly enlarged and had regular
shape. No functional disorders were
revealed. Specify the process that
developed in the right kidney:
A. Vicarious hypertrophy
B. Working hypertrophy
C. Hypertrophic growth
D. Pseudohypertrophy
E. Metaplasia
 Krok 1 Medicine 2014
161. In allergic diseases, a dramaic
increase in basophilic leukocyte
number in patients’ blood is observed.
This phenomenon is due to the followi-
ng basophil function:
A. Participation of heparin and histami-
ne in metabolism
B. Phagocytosis of microorganisms and
small particles
C. Immunoglobulin synthesis
D. Phagocytosis of immune complexes
E. Participation in blood clotting
162. A 47-year-old male patient
developed intestinal colic against the
background of essential hypertension.
In this situation it would be most effi-
cient to arrest the colic by using drugs
of the following group:
A. Myotropic antispasmodics
B. Anticholinesterase agents
C. Sympathomimetics
D. M-cholinomimetics
E. Adrenomimetics
163. A patient has been admitted to the
contagious isolation ward with signs
of jaundice caused by hepatitis virus.
Which of the symptoms given below
is strictly specific for hepatocellular
jaundice?
A. Increase of ALT, AST level
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholemia
E. Urobilinuria
164. An underage patient has signs of
achondroplasia (dwarfism). It is known
that this is a monogenic disease and
the gene that is responsible for the
development of such abnormalities is
a dominant one. The development of
that child’s brother is normal. Specify
the genotype of the healthy child:
A. aa
B. AA
C. Aa
D. AaBb
E. AABB
165. A patient has acute bronchitis.
The fever up to 38, 5o C had lasted for a
week, presently there is a decrease in
20
temperature down to 37, 0oC . Specify
the leading mechanism in the 3rd stage
of fever:
A. Peripheral vasodilation
B. Increased heat production
C. Development of chill
D. Increased diuresis
E. Increased respiratory rate
166. A 35-year-old female patient
has undergone biopsy of the breast
nodules. Histological examination has
revealed enhanced proliferation of
the small duct and acini epithelial
cells, accompanied by the formation of
glandular structures of various shapes
and sizes, which were located in the fi-
brous stroma. What is the most likely
diagnosis?
A. Fibroadenoma
B. Adenocarcinoma
C. Cystic breast
D. Invasive ductal carcinoma
E. Mastitis
167. At a bacteriological laboratory
animal skins are analyzed by means
of Ascoli precipitaion test. What is
detected if the reaction is positive?
A. Anthrax agent antigens
B. Anaerobic infection toxin
C. Brucellosis agent
D. Yersinia surface antigen
E. Plague agent
168. Examination of the duodenal
contents revealed some pear-shaped
protozoa with two nuclei and four pai-
rs of flagella. The organisms had also
two axostyles between the nuclei and a
ventral adhesive disc. What protozoan
representative was found in the pati-
ent?
A. Lamblia
B. Toxoplasma
C. Leishmania
D. Intestinal trichomonad
E. Trypanosome
169. A 36-year-old female patient
has a history of B2 -hypovitaminosis.
The most likely cause of speci-
fic symptoms (epithelial, mucosal,
cutaneous, corneal lesions) is the defi-
 Krok 1 Medicine 2014
ciency of:
A. Flavin coenzymes
B. Cytochrome A1
C. Cytochrome oxidase
D. Cytochrome B
E. Cytochrome C
170. A 54-year-old female was brought
to the casualty department after a car
accident. A traumatologist diagnosed
her with multiple fractures of the lower
extremities. What kind of embolism is
most likely to develop in this case?
A. Fat
B. Tissue
C. Thromboembolism
D. Gaseous
E. Air
171. A blood drop has been put into a
test tube with 0,3% solution of NaCl.
What will happen to erythrocytes?
A. Osmotic haemolysis
B. Shrinkage
C. Mechanical haemolysis
D. Any changes will be observed
E. Biological haemolysis
172. 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, wi-
th 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?
A. Adrenal gland
B. Thyroid gland
C. Pituitary gland
D. Epiphysis
E. Hypothalamus
173. Histological specimen of a 10-day
human embryo represents 2 contacting
sacs (amniotic and yolk sacs). Specify
the structure that separates the amni-
otic cavity from the yolk sac:
A. Embryonic shield
B. Amniotic stalk
C. Floor of the amniotic sac
D. Roof of the yolk sac
E. Extraembryonic mesoderm
21
174. An electron micrograph shows
a cell of neural origin. The terminal
portion of the cell dendrite has cyli-
ndrical shape and consists of 1000
closed membrane disks. What cell is
represented by the micrograph?
A. Rod receptor cell
B. Cone receptor cell
C. Spinal node neuron
D. Neuron of the cerebral cortex
E. Neuron of the anterior horns of the
spinal cord
175. Disruption of nerve fiber myeli-
nogenesis causes neurological di-
sorders and mental retardation. These
symptoms are typical for heredi-
tary and acquired alterations in the
metabolism of:
A. Sphingolipids
B. Neutral fats
C. Higher fatty acids
D. Cholesterol
E. Phosphatidic acid
176. A patient underwent surgical
removal of a cavitary liver lesion 2
cm in diameter. It was revealed that
the cavity wall was formed by dense
fibrous connective tissue; the cavi-
ty contained muddy, thick, yellowish-
greenish fluid with an unpleasant
odor. Microscopically, the fluid consi-
sted mainly of polymorphonuclear
leukocytes. What pathological process
are these morphological changes typi-
cal for?
A. Chronic abscess
B. Acute abscess
C. Phlegmon
D. Empyema
E. -
177. A patient complains of
photoreception disorder and frequent
acute viral diseases. He has been
prescribed a vitamin that affects
photoreception processes by produci-
ng rhodopsin, the photosensitive pi-
gment. What vitamin is it?
 Krok 1 Medicine 2014
A. Retinol acetate
B. Tocopherol acetate
C. Pyridoxine hydrochloride
D. Cyanocobalamin
E. Thiamine
178. A 7-year-old boy got ill with di-
phtheria. On the third day he di-
ed of asphyxiation. At autopsy the
mucosa of the larynx, trachea and
bronchi had thickened, edematous,
lustreless appearance and was covered
with gray films which could be easily
removed. Specify the type of laryngeal
inflammation:
A. Croupous
B. Diphtheritic
C. Purulent
D. Catarrhal
E. Intermediate
179. A child has a history of
hepatomegaly, hypoglycemia, seizures,
especially on an empty stomach and
in stressful situations. The child is di-
agnosed with Gierke disease. This di-
sease is caused by the genetic defect of
the following enzyme:
A. Glucose-6-phosphatase
B. Amyloid-1,6-glycosidase
C. Phosphoglucomutase
D. Glycogen phosphorylase
E. Glucokinase
180. A public utility specialist went
down into a sewer well without
protection and after a while lost
consciousness. Ambulance doctors di-
agnosed him with hydrogen sulfide
intoxication. What type of hypoxia
developed?
A. Hemic
B. Overload
C. Tissue
D. Circulatory
E. Respiratory
181. A child with a normal karyotype
is diagnosed with cleft lip and
hard palate, defects of the cardi-
ovascular system, microcephaly. The
child’s mother suffered rubella during
pregnancy. This pathology in the child
may be an example of:
22
A. Genocopy
B. Trisomy
C. Phenocopy
D. Monosomy
E. -
182. A 28-year-old patient undergoi-
ng treatment in the pulmonological
department has been diagnosed wi-
th pulmonary emphysema caused by
splitting of alveolar septum by tissular
tripsin. The disease is cased by the
congenital deficiency of the following
protein:
A. α1 -proteinase inhibitor
B. α2 -macroglobulin
C. Cryoglobulin
D. Haptoglobin
E. Transferrin
183. A patient with signs of
osteoporosis and urolithiasis has
been admitted to the endocri-
nology department. Blood test
has revealed hypercalcemia and
hypophosphatemia. These changes are
associated with abnormal synthesis of
the following hormone:
A. Parathyroid hormone
B. Calcitonin
C. Cortisol
D. Aldosterone
E. Calcitriol
184. During a surgery for femoral
hernia a surgeon operates within the
boundaries of femoral trigone. What
structure makes up its upper margin?
A. Lig.inguinale
B. Arcus iliopectineus
C. Lig.lacunare
D. Lig. pectinale
E. Fascia lata
185. A 19-year-old victim has been
delivered to the casualty department
with a cut wound of the trapezius
muscle. Which of the cervical fasciae
forms a sheath for this muscle?
 Krok 1 Medicine 2014
A. Investing layer of cervical fascia
B. Muscular part of the pretacheal layer
of cervical fascia
C. Visceral part of the pretracheal layer
of cervical fascia
D. Prevertebral layer of cervical fascia
E. Carotid sheath of cervical fascia
186. A patient with acne has been
prescribed doxycycline hydrochloride.
What recommendations should be gi-
ven to the patient, while he is taking
this drug?
A. Avoid long stay in the sun
B. Take with large quantity of liquid,
preferably milk
C. Take before meal
D. The course of treatment should not
exceed 1 day
E. Do not take with vitamins
187. A 30-year-old patient with a past
history of virus B hepatitis complains
of prolonged nosebleeds. What drug
will be most efficient in remedying this
condition?
A. Vicasolum
B. Fraxiparine
C. Folic acid
D. Dipiridamol
E. Asparcam
188. A patient has arterial hypertensi-
on. What long-acting drug from the
group of calcium channel blockers
should be prescribed?
A. Amlodipine
B. Octadine
C. Pyrroxanum
D. Atenolol
E. Reserpine
189. A patient has been diagnosed
with ARVI. Blood serum contains
immunoglobulin M. What is the stage
of infection in this case?
A. Acute
B. Prodromal
C. Incubation
D. Reconvalescence
E. Carriage
190. In a dysentery patient undergoing
treatment in the contagious isolation
ward, a significant increase in packed
23
cell volume has been observed (60%).
What other value will be affected by
this change?
A. Increasing blood viscosity
B. Increasing volume of blood circulati-
on
C. Leukopenia
D. Thrombocytopenia
E. Increasing erythrocyte sedimentati-
on rate (ESR)
191. A patient complains of palpi-
tation after stress. The pulse is 104
bpm, P-Q=0,12 seconds, there are no
changes of QRS complex. What type
of arrhythmia does the patient have?
A. Sinus tachycardia
B. Sinus bradycardia
C. Sinus arrhythmia
D. Ciliary arrhythmia
E. Extrasystole
192. A 30-year-old patient has
undergone keratoplasty in the
transplantation center, cornea has been
taken fron a donor, who died in a road
accident. What kind of transplantation
was performed?
A. Allotransplantation
B. Autotransplantation
C. Xenotransplantation
D. Explantation
E. Heterotransplantation
193. A 29-year-old male with a knife
wound of neck presents with bleedi-
ng. During the initial d-bridement of
the wound the surgeon revealed the
injury of a vessel found along the
lateral edge of the sternocleidomastoid
muscle. Specify this vessel:
A. V. jugularis externa
B. V. jugularis anterior
C. A. carotis externa
D. A. carotis interna
E. V. jugularis interna
194. A histologic specimen represents
an organ with walls comprised
of mucous, submucous, fibrous-
cartilaginous and adventitial membranes.
Epithelium is multirowed and ciliated,
muscular layer of mucous membrane is
absent, submucous membrane contai-
 Krok 1 Medicine 2014
ns serous-mucous glands, hyaline
cartilage forms open circles. What
organ has the described morphologi-
cal features?
A. Trachea
B. Tertiary bronchi (segmental bronchi)
C. Secondary bronchi (lobar bronchi)
D. Terminal bronchiole
E. Larynx
195. In cancer patients who have been
continuously receiving methotrexate,
the target cells of tumor with time
become insensitive to this drug. In this
case, gene amplification of the followi-
ng enzyme is observed:
A. Dihydrofolate reductase
B. Thiaminase
C. Deaminase
D. Thioredoxin reductase
E. -
196. Pancreas is known as a mixed
gland. Endocrine functions include
production of insulin by beta cells. This
hormone affects the metabolism of
carbohydrates. What is its effect upon
the activity of glycogen phosphorylase
(GP) and glycogen synthase (GS)?
A. It inhibits GP and activates GS
B. It activates both GP and GS
C. It inhibits both GP and GS
D. It activates GP and inhibits GS
E. It does not affect the activity of GP
and GS
197. A patient has the oxyhemoglobin
dissociation curve shifted to the left.
What blood changes induce this condi-
tion?
24
A. Alkalosis, hypocapnia, temperature
drop
B. Acidosis, hypercapnia, temperature
rise
C. Acidosis, hypercapnia, temperature
drop
D. Acidosis, hypocapnia, temperature
rise
E. -
198. Administration of doxycycline
hydrochloride caused an imbalance
of the symbiotic intestinal microflora.
Specify the kind of imbalance caused
by the antibiotic therapy:
A. Dysbacteriosis
B. Sensibilization
C. Idiosyncrasy
D. Superimposed infection
E. Bacteriosis
199. A patient with signs of emotional
lability that result in troubled sleep has
been prescribed nitrazepam. Specify
the sleep-inducing mechanism of this
drug:
A. GABA-ergic system activation
B. Blockade of opiate receptors
C. Inhibition of stimulating amino acids
D. H1-histamine receptors stimulation
E. Supression of serotonergic
neurotransmission
200. A patient has been found to have
a marked dilatation of saphenous vei-
ns in the region of anterior abdomi-
nal wall around the navel. This is
symptomatic of pressure increase in
the following vessel:
A. V. portae hepatis
B. V. cava superior
C. V. cava inferior
D. V. mesenterica inferior
E. V. mesenterica superior
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
1. Characteristic sign of glycogenosis is
muscle pain during physical work. Blood
examination usually reveals hypoglycemia.
This pathology is caused by congenital defi-
ciency of the following enzyme:
A. Glycogen phosphorylase
B. Glucose 6-phosphate dehydrogenase
C. α-amylase
D. γ -amylase
E. Lysosomal glycosidase
2. Histologic specimen of a kidney
demonstrates cells closely adjoined to the
renal corpuscle in the distal convoluted
tubule. Their basement membrane is
extremely thin and has no folds. These cells
sense the changes in sodium content of uri-
ne and influence renin secretion occurring
in juxtaglomerular cells. Name these cells:
A. Macula densa cells
B. Juxtaglomerular cells
C. Mesangial cells
D. Podocytes
E. Glomerular capillary endothelial cells
3. A 46-year-old female patient has conti-
nuous history of progressive muscular
(Duchenne’s) dystrophy. Which blood
enzyme changes will be of diagnostic value
in this case?
A. Creatine phosphokinase
B. Lactate dehydrogenase
C. Pyruvate dehydrogenase
D. Glutamate dehydrogenase
E. Adenylate cyclase
4. A laboratory experiment on a dog
was used to study central parts of audi-
tory system. One of the mesencephalon
structures was destroyed. The dog has lost
the orienting response to auditory signals.
What structure was destroyed?
A. Inferior colliculi of corpora quadrigemina
B. Superior colliculi of corpora quadrigemina
C. Substantia nigra
D. Reticular formation nuclei
E. Red nucleus
5. A patient has decreased concentrati-
on of magnesium ions that are requi-
red for ribosomes connection to granular
endoplasmic reticulum. This condition is
known to disrupt the process of protein bi-
osynthesis. Disruption occurs at the followi-
ng stage:
A. Translation
B. Transcription
C. Replication
D. Amino acids activation
E. Processing
1
6. A 6-year-old child with suspected acti-
ve tuberculous process has undergone di-
agnostic Mantoux test. What immunobi-
ological preparation was injected?
A. Tuberculin
B. BCG vaccine
C. DTP vaccine
D. Tularinum
E. Td vaccine
7. During postembryonal haemopoiesis
in red bone marrow the cells of one of
the cellular differons demonstrate gradual
decrease in cytoplasmic basophilia as well
as increase in oxyphilia, the nucleus is being
forced out. Such morphological changes are
typical for the following haemopoiesis type:
A. Erythropoiesis
B. Lymphopoiesis
C. Neutrophil cytopoiesis
D. Eosinophil cytopoiesis
E. Basophil cytopoiesis
8. When taking exams students often have
dry mouth. The mechanism that causes this
state results from the following reflexes:
A. Conditioned sympathetic
B. Unconditioned parasympathetic
C. Conditioned parasympathetic
D. Unconditioned sympathetic
E. Unconditioned peripheral
9. A 67-year-old patient with clini-
cal diagnosis of chronic bronchitis,
pneumosclerosis, and cardiopulmonary
decompensation has the biopsy material
taken from the suspicious area in his right
bronchus mucosa. Cellular and tissue atypi-
sm along with pearly bodies can be histologi-
cally detected. What pathologic process is
characterized by the described histological
changes?
A. Squamous cell carcinoma of bronchus
with keratinization
B. Polypoid chronic bronchitis
C. Bronchiectasis
D. Acute bronchitis
E. Squamous cell metaplasia of bronchial
mucosa
10. A microspecimen of heart shows
rectangular cells from 50 to 120 micrometers
large with central position of nucleus
and developed myofibrils. The cells are
connected by intercalated discs. These cells
are responsible for the following function:
A. Function of heart contractions
B. Function of impulse conduction
C. Endocrine
D. Protective
E. Regeneratory
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 2

11. Untrained people often have muscle A. Gastrin

pain after sprints as a result of lactate B. Histamine
accumulation. This can be caused by C. Secretin
intensification of the following biochemical D. Cholecystokinin
process: E. Neurotensin
A. Glycolysis 17. Atretic bodies and developed yellow
B. Gluconeogenesis body can be observed along with follicles
C. Pentose phosphate pathway of various orders in an ovary specimen.
D. Lipogenesis What stage of ovarian and menstrual cycle is
E. Glycogenesis characterized by the described ovary condi-
tion?
12. Poisoning caused by botulinum toxin
that prevents calcium ions from entering A. Premenstrual
axone nerve endings of motoneurons is life- B. Menstrual
threatening because it can lead to: C. Postmenstrual
D. Regeneration
A. Respiratory arrest E. Follicle growth
B. Cardiac arrest
C. Vasotonic disorder 18. A 16-year-old adolescent is di-
D. Vomiting agnosed with hereditary UDP (uridine di-
E. Diarrhea phosphate) glucuronyltransferase defici-
ency. Laboratory tests revealed hyperbili-
13. Increased HDL levels decrease the risk rubinemia caused mostly by increased blood
of atherosclerosis. What is the mechanism of content of the following substance:
HDL anti-atherogenic action?
A. Unconjugated bilirubin
A. They remove cholesterol from tissues B. Conjugated bilirubin
B. They supply tissues with cholesterol C. Urobilinogen
C. They are involved in the breakdown of D. Stercobilinogen
cholesterol E. Biliverdine
D. They activate the conversion of
cholesterol to bile acids 19. Prior to glucose utilization in cells it is
E. They promote absorption of cholesterol in transported inside cells from extracellular
the intestine space through plasmatic membrane. This
process is stimulated by the following
14. It has been found out that one of a pesti- hormone:
cide components is sodium arsenate that
blocks lipoic acid. Which enzyme activity A. Insulin
is impaired by this pesticide? B. Glucagon
C. Thyroxin
A. Pyruvate dehydrogenase complex D. Aldosterone
B. Microsomal oxidation E. Adrenalin
C. Methemoglobin reductase
D. Glutathione peroxidase 20. After implantation of a cardiac valve
E. Glutathione reductase a young man systematically takes indirect
anticoagulants. His state was complicated
15. A drycleaner’s worker has been found to by hemorrhage. What substance content has
have hepatic steatosis. This pathology can decreased in blood?
be caused by the disruption of synthesis of
the following substance: A. Prothrombin
B. Haptoglobin
A. Phosphatidylcholine C. Heparin
B. Tristearin D. Creatin
C. Urea E. Ceruloplasmin
D. Phosphatidic acid
E. Cholic acid 21. A 12-year-old patient has white non-
pigmented spots on the skin. The spots
16. A 35-year-old man with peptic ulcer di- appeared after the patient became 10 years
sease has undergone antrectomy. After the old, and they constantly grow. This spots
surgery secretion of the following gastro- appeared due to the lack of the following
intestinal hormone will be disrupted the skin cells:
most:
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 3

A. Melanocytes A. Klinefelter’s syndrome

B. Adipocytes B. Down’s disease
C. Fibrocytes C. Turner’s syndrome
D. Plasmocytes D. Triple X syndrome
E. Labrocytes E. Hypophosphatemic rickets
22. A group of Ukrainian tourists returning 27. Pure culture of microorganisms was
from Samarqand was bringing with them obtained from pharynx of a child with
gerbils. During examination in customs offi- suspected diphtheria. Morphologic, tinctori-
ce ulcers were detected on the skin of the al, cultural, and biochemical properties
animals. What protozoa is the most likely to of the microorganisms were studied and
cause the disease in the animals, if mosqui- revealed to be characteristic of diphtheria
tos are the carriers? agents. What investigation should be addi-
tionally performed to make a conclusion,
A. Leishmania tropica major that these microorganisms are pathogenic
B. Balantidium coli diphtheria bacilli?
C. Plasmodium falciparum
D. Trypanosoma cruzi A. Determine toxigenic properties
E. Toxoplasma gondii B. Determine proteolytic properties
C. Determine urease activity
23. A 5-year-old child has been diagnosed D. Determine cystinase activity
with acute right distal pneumonia. Sputum E. Determine amylolytic activity
inoculation revealed that the causative
agent is resistant to penicillin and senstive 28. Autopsy of a man who had tuberculosis
to macrolides. What drug should be prescri- revealed a 3x2 cm large cavity in the superi-
bed? or lobe of the right lung. The cavity was
interconnected with a bronchus, its wall
A. Azithromycin was dense and consisted of three layers: the
B. Tetracycline internal layer was pyogenic, the middle layer
C. Gentamycin was made of tuberculous granulation tissue
D. Streptomycin and the external one was made of connecti-
E. Ampicillin ve tissue. What is the most likely diagnosis?
24. To an emergency ward a 7-year-old A. Fibrous cavernous tuberculosis
child was delivered in the condition of B. Fibrous focal tuberculosis
allergic shock caused by a bee sting. High C. Tuberculoma
concentration of histamine is observed in D. Acute focal tuberculosis
blood. Production of this amine is the result E. Acute cavernous tuberculosis
of the following reaction:
29. A 7-year-old child has acute onset of di-
A. Decarboxylation sease: temperature rise up to 38o C , rhinitis,
B. Hydroxylation cough, lacrimation, and large-spot rash on
C. Dehydrogenation the skin. Pharyngeal mucosa is edematous,
D. Deaminization hyperemic, with whitish spots in the buccal
E. Reduction area. What kind of inflammation causes the
changes in the buccal mucosa?
25. A 65-year-old man suffering from gout
complains of pain in his kidneys. Ultrasonic A. Catarrhal inflammation
examination revealed kidney stones. A B. Suppurative inflammation
certain substance in increased concentration C. Fibrinous inflammation
can cause kidney stones formation. Name D. Hemorrhagic inflammation
this substance: E. Serous inflammation
A. Uric acid 30. Analysis of sputum taken from a patient
B. Cholesterol with suspected pneumonia revealed slightly
C. Bilirubin elongated gram-positive diplococci with poi-
D. Urea nted opposite ends. What microorganisms
E. Cystine were revealed in the sputum?
26. Sex chromatin was detected during A. Streptococcus pneumoniae
examination of a man’s buccal epitheli- B. Staphylococcus aureus
um. It is characteristic of the following C. Klebsiella pneumoniae
chromosome disease: D. Neisseria meningitidis
E. Neisseria gonorrhoeae
31. Serological diagnostics of infectious di-
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
seases is based upon specific interaction with
antigenes. Specify the serological reaction
that underlies adhesion of microorganisms
when they are affected by specific antibodi-
es in presence of an electrolyte:
A. Agglutination reaction
B. Precipitation reaction
C. Complement-binding reaction
D. Hemadsorption reaction
E. Neutralization reaction
32. A 4-year-old child was admitted to an
orthopaedic department with displaced shin
fracture. Bone fragments reposition requires
analgesia. What drug should be chosen?
A. Promedol
B. Analgin
C. Morphine hydrochloride
D. Panadol
E. -
33. Doctors make mostly radial incisions
during mammary gland surgery. What parti-
culars of anatomical organization make such
surgical technique preferable?
A. Lobe apexes converge towards nipples
B. Lobe bases radiate from nipples
C. Transversal position of gland lobes
D. Vertical position of gland lobes
E. -
34. A 41-year-old man has a history of
recurrent attacks of heartbeats (paroxysms),
profuse sweating, headaches. Examinati-
on revealed hypertension, hyperglycemia,
increased basal metabolic rate, and
tachycardia. These clinical presentations are
typical for the following adrenal pathology:
A. Hyperfunction of the medulla
B. Hypofunction of the medulla
C. Hyperfunction of the adrenal cortex
D. Hypofunction of the adrenal cortex
E. Primary aldosteronism
35. A 12-year-old child has developed
nephritic syndrome (proteinuria, hematuria,
cylindruria) 2 weeks after the case of tonsi-
llitis, which is a sign of affected glomerular
basement membrane in the kidneys. What
mechanism is the most likely to cause the
basement membrane damage?
A. Immune complex
B. Granulomatous
C. Antibody-mediated
D. Reaginic
E. Cytotoxic
36. Several minutes after a dentist admini-
stered novocaine for local anaesthesia of
a patient’s tooth, the following symptoms
sharply developed in the patient: fatigue,
4
skin itching. Objectively the following can
be observed: skin hyperemia, tachycardia,
BP dropped down to 70/40 mm Hg. What
kind of allergic reaction is this pathology?
A. Anaphylactic
B. Cytotoxic
C. Stimulating
D. Cell-mediated immune reaction
E. Immune complex
37. A patient with probable liver abscess
was delivered to a surgical department. The
patient for a long time had been on an
assignment in an African country and had
recurrent cases of acute gastrointestinal di-
sturbance. What protozoan disease can it
be?
A. Amebiasis
B. Trypanosomiasis
C. Leishmaniasis
D. Malaria
E. Toxoplasmosis
38. 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:
A. Alveolar macrophages
B. Respiratory epithelial cells
C. Secretory epithelial cells
D. Capillary endothelial cells
E. Pericapillary cells
39. Electrical activity of neurons is being
measured. They fire prior to and at the
beginning of inhalation. Where are these
neurons situated?
A. Medulla oblongata
B. Diencephalon
C. Mesencephalon
D. Spinal cord
E. Cerebral cortex
40. Electrocardiogram analysis demonstrates
that cardiac cycle of a human equals 1
second. It means that heart rate per minute
equals:
A. 60
B. 50
C. 70
D. 80
E. 100
41. Glomerular filtration of a person, who
has been starving for a long time, has
increased by 20%. The most likely cause of
filtration changes in the given conditions is:
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
A. Decrease of blood plasma oncotic
pressure
B. Increase of systemic blood pressure
C. Increase of renal filter permeability
D. Increase of filtration factor
E. Increase of renal plasma flow
42. Cells of healthy liver actively synthesize
glycogen and proteins. What organelles are
the most developed in them?
A. Granular and agranular endoplasmic
reticulum
B. Cell center
C. Lysosomes
D. Mitochondria
E. Peroxisomes
43. Atria of an experimental animal were
superdistended with blood, which resulted
in decreased reabsorption of N a+ and water
in renal tubules. This can be explained by
the influence of the following factor on ki-
dneys:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
44. A patient with hypertensic crisis has
increased content of angiotensin II in blood.
Angiotensin pressor effect is based on:
A. Contraction of arteriole muscles
B. Activation of biogenic amine synthesis
C. Prostaglandin hyperproduction
D. Vasopressin production stimulation
E. Activation of kinin–kallikrein system
45. A 43-year-old-patient has arterial
hypertension caused by increase in cardi-
ac output and general peripheral resi-
stance. Specify the variant of hemodynamic
development of arterial hypertension in the
given case:
A. Eukinetic
B. Hyperkinetic
C. Hypokinetic
D. Combined
E. -
46. A patient has been hospitalised
with provisional diagnosis of virus B
hepatitis. Serological reaction based on
complementation of antigen with antibody
chemically bound to peroxidase or alkaline
phosphatase has been used for disease di-
agnostics. Name this serological reaction:
5
A. Immune-enzyme analysis
B. Radioimmunoassay technique
C. Immunofluorescence test
D. Bordet-Gengou test
E. Antigen-binding assay
47. A surgeon has to find the common
hepatic duct during operative intervention
for treatment of concrements in the gall
ducts. The common hepatic duct is located
between the leaves of:
A. Hepatoduodenal ligament
B. Hepatogastric ligament
C. Hepatorenal ligament
D. Round ligament of liver
E. Venous ligament
48. It is known that the gene responsible for
development of blood groups according to
AB0 system has three allele variants. Exi-
stence of the IV blood group can be explai-
ned by the following variability form:
A. Combinative
B. Mutational
C. Phenotypic
D. Genocopy
E. Phenocopy
49. When measuring power inputs of a
person by the method of indirect calori-
metry the following results were obtai-
ned: oxygen consumption is 1000 ml and
carbon dioxide production is 800 ml per mi-
nute. The person under examination has the
following respiratory coefficient:
A. 0,8
B. 1,25
C. 0,9
D. 0,84
E. 1,0
50. 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?
A. Hypospadias
B. Hermaphroditism
C. Epispadia
D. Monorchism
E. Cryptorchidism
51. Poisoning caused by mercury (II) chlori-
de (corrosive sublimate) occurred in the
result of safety rules violation. In 2 days
the patient’s diurnal diuresis became 620
ml. The patient developed headache, vomiti-
ng, convulsions, dyspnea; moist crackles are
observed in the lungs. Name this pathology:
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
A. Acute renal failure
B. Chronic renal failure
C. Uremic coma
D. Glomerulonephritis
E. Pyelonephritis
52. 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 perspi-
ratory glands:
A. Aldosterone
B. Vasopressin
C. Cortisol
D. Tgyroxin
E. Natriuretic
53. Along with normal hemoglobin types
there can be pathological ones in the organi-
sm of an adult. Name one of them:
A. HbS
B. HbF
C. HbA1
D. HbA2
E. HbO2
54. Emotional stress causes activation of
hormon-sensitive triglyceride lipase in the
adipocytes. What secondary mediator takes
part in this process?
A. Cyclic adenosine monophosphate
B. Cyclic guanosine monophosphate
C. Adenosine monophosphate
D. Diacylglycerol
E. Ions of 2+
55. A patient has been diagnosed with
alkaptonuria. Choose an enzyme that can
cause this pathology when deficient:
A. Homogentisic acid oxidase
B. Phenylalanine hydroxylase
C. Glutamate dehydrogenase
D. Pyruvate dehydrogenase
E. Dioxyphenylalanine decarboxylase
56. 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:
A. Tractus rubrospinalis
B. Tractus corticospinalis
C. Tractus corticonuclearis
D. Tractus spinothalamicus
E. Tractus tectospinalis
57. A child is 10 years old. The followi-
ng presentations have developed: sharp
pain during swallowing, swollen neck, body
temperature rise up to 39, 0o C , bright-red fi-
nely papular rash all over the body. Pharynx
6
and tonsils are sharply hyperemic ("flaming
pharynx"), "crimson tongue". On the tonsi-
ls surface there are isolated greyish necrosis
focuses. What disease it might be?
A. Scarlet fever
B. Meningococcal nasopharyngitis
C. Diphtheria
D. Influenza
E. Measles
58. A patient suffers from intermi-
ttent fevers and normalizations of body
temperature that occur during the day. The
temperature rise is observed regularly every
fourth day. Specify the type of temperature
curve:
A. Febris internuttens
B. Febris continua
C. Febris reccurens
D. Febris hectica
E. Febris remitens
59. A woman with the III (В), Rh- blood
group gave birth to a child with the II (А)
blood group. The child is diagnosed with
hemolytic disease of newborn caused by
rhesus incompatibility. What blood group
and Rh can the father have?
A. II (А), Rh+
B. I (0), Rh+
C. III (B), Rh+
D. I (0), Rh−
E. II (A), Rh−
60. A patient is diagnosed with hereditary
coagulopathy that is characterised by factor
VIII deficiency. Specify the phase of blood
clotting during which coagulation will be di-
srupted in the given case:
A. Thromboplastin formation
B. Thrombin formation
C. Fibrin formation
D. Clot retraction
E. -
61. Angiocardiography of a 60-year-old man
revealed constriction of the vessel located in
the left coronary sulcus of his heart. Name
this pathological vessel:
A. Ramus circumflexus
B. Ramus interventricularis posterior
C. A. coronaria dextra
D. V. cordis parva
E. Ramus interventricularis anterior
62. A patient complains of pain in the ri-
ght lateral abdomen. Palpation revealed a
dense, immobile, tumor-like formation. The
tumor is likely to be found in the following
part of the digestive tube:
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
A. Colon ascendens
B. Colon transversum
C. Colon descendens
D. Colon sigmoideum
E. Caecum
63. During regular check-up a child is
detected with interrupted mineralization of
the bones. What vitamin deficiency can be
the cause?
A. Calciferol
B. Riboflavin
C. Tocopherol
D. Folic acid
E. Cobalamin
64. During hystological analysis of the
lymph node situated in the posterior
neck triangle of an 18-year-old pati-
ent a morphologist detected a cluster
of cells including the following: isolated
multinucleate Reed-Sternberg cells, large
and small Hodgkin’s cells and numerous
lymphocytes, isolated plasma cells, eosi-
nophils. What disease has developed in the
patient?
A. Lymphogranulomatosis
B. Nodular lymphoma
C. Burkitt’s lymphoma
D. Lymphocytic lymphoma
E. Chronic lymphocytic leukemia
65. An infant has pylorospasm, weakness,
hypodynamia, convulsions as a result of
frequent vomiting. What kind of acid-base
disbalance is it?
A. Excretory alkalosis
B. Excretory acidosis
C. Metabolic acidosis
D. Exogenous nongaseous acidosis
E. Gaseous alkalosis
66. A 39-year-old man who had been
operated for the stomach ulcer died 7
days after the surgery. Autopsy revealed
that peritoneal leaves were dull, plephoric,
covered with massive yellow-greenish films,
the peritoneal cavity contained about 300
ml of thick yellow-greenish liquid. What
pathologic process was revealed in the peri-
toneal cavity?
A. Fibrinous suppurative peritonitis
B. Serous peritonitis
C. Fibrinous serous peritonitis
D. Peritoneal commissures
E. Fibrinous haemorrhagic peritonitis
67. Monoamine oxidase inhibitors are
widely used as psychopharmacological
drugs. They change the level of nearly
all neurotransmitters in synapses, with
the following neurotransmitter being the
7
exception:
A. Acetylcholine
B. Noradrenaline
C. Adrenaline
D. Dopamine
E. Serotonin
68. A patient with urolithiasis has developed
severe pain attacks. For pain shock preventi-
on he was administered an antispasmodic
narcotic analgesic along with atropine.
Name this drug:
A. Promedol
B. Nalorphine
C. Tramadol
D. Ethylmorphine hydrochloride
E. Morphine hydrochloride
69. A patient with acute myocardial infarcti-
on has been administered heparin as a part
of complex therapy. Some time after heparin
injection the patient developed hematuria.
What heparin antagonist should be injected
to remove the complication?
A. Protamine sulfate
B. Vicasol
C. Aminocaproic acid
D. Neodicumarin
E. Fibrinogen
70. 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:
A. Iron refractory anemia
B. Iron-deficiency anemia
C. Minkowsky-Shauffard disease
D. Hypoplastic anemia
E. Metaplastic anemia
71. Despite the administration of cardi-
otonics and thiazide diuretic a patient with
chronic heart failure has persistent edemas
and the risk of ascites arose. What medicati-
on should be administered to enhance the
diuretic effect of the administered drugs?
A. Spironolactone
B. Furosemide
C. Amiloride
D. Clopamide
E. Manithol
72. Acute renal impairment caused death
of a patient with hemorrhage. Autopsy
revealed enlarged kidneys with broad pale-
pink cortical layer expressively demarcated
from dark-red renal pyramids. Macroscopic
examination revealed lack of epithelial
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 8

nuclei of convoluted tubules, tubulorrhexis, th hepatic coma. Disorders of the central

phlebostasis. The cell nuclei of choroid nervous system develop due to accumulati-
glomus and straight tubules were present. on of the following metabolite:
What pathology is it?
A. Ammonia
A. Necronephrosis B. Urea
B. Infarction C. Glutamine
C. Glomerulonephritis D. Bilirubin
D. Pyelonephritis E. Histamine
E. Nephrosis
77. When playing a child received a hit to the
73. A 3-year-old child with meningeal presternum region. As a result of this trauma
symptoms died. Postmortem macroscopy an organ located behind the presternum was
of the pia matter revealed miliary nodules damaged. Name this organ:
which were microscopically represented by
a focus of caseous necrosis with masses of A. Thymus
epithelioid and lymphoid cells with large B. Thyroid gland
cells containing crescent-shaped peripheral C. Heart
nuclei situated between them. Specify the D. Pericardium
type of meningitis in the child: E. Larynx

A. Tuberculous 78. A child suffers from dry cough. What

B. Syphilitic
C. Brucellar
D. Grippal
E. Meningococcal
74. A 66-year-old woman had intravenous
injection of magnesium sulfate solution
to stop hypertensive crisis. However her
arterial pressure did not decrease and
after repeated introduction of the same
preparation she developed sluggishness,
slow response to stimuli; the patient is
unconsciousness and her respiration is inhi-
bited. What preparation is antagonist of
magnesium sulfate and can remove the
symptoms of its overdose?
non-narcotic antitussive drug will relieve the
patient’s condition?
A. Glaucine hydrochloride
B. Codeine phosphate
C. Morphine hydrochloride
D. Potassium iodide
E. Althaea officinalis root extract
79. A patient complains of acute pain attacks
in the right lumbar region. During exami-
nation a nephrolithic obturation of the ri-
ght ureter in the region between its abdomi-
nal and pelvic segments has been detected.
What anatomical boundary exists between
those two segments?

A. Calcium chloride A. Linea terminalis

B. Potassium chloride B. Linea semilunaris
C. Sodium chloride C. Linea arcuata
D. Activated carbon D. Linea transversa
E. Potassium permanganate E. Linea inguinalis

75. A patient working at a pig farm complai-
ns of paroxysmal abdominal pain, liquid
feces with mucus and blood, headache,
weakness, fever. Examination of large
intestine revealed ulcers from 1 mm up to
several cm in diameter, feces contained oval
unicellular organisms with cilia. What di-
sease can be suspected?
A. Balantidiasis
B. Amebiasis
C. Toxoplasmosis
D. Lambliasis
E. Trichomoniasis
76. An unconscious patient was delivered
by ambulance to the hospital. On objecti-
ve examination the patient was found to
present no reflexes, periodical convulsi-
ons, irregular breathing. After laboratory
examination the patient was diagnosed wi-
80. 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:
A. Angiotensin II
B. Angiotensinogen
C. Renin
D. Catecholamines
E. Norepinephrine
81. In a village a case of anthrax has been
registered. Medical services began epidemi-
ologically indicated specific prophylaxis of
population against anthrax. What preparati-
on was used for this purpose?
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 9

A. Live vaccine Objectively: the patient’s weight is 117

B. Inactivated vaccine kg, he has moon-like hyperemic face, red-
C. Chemical vaccine blue striae of skin distension on his belly.
D. Genetically engineered vaccine Osteoporosis and muscle dystrophy are
E. Anatoxin present. AP is 210/140 mm Hg. What is the
most probable diagnosis?
82. Experimental stimulation of the
sympathetic nerve branches that innervate A. Cushing’s disease
the heart caused an increase in the force of B. Cushing’s syndrome
heart contractions because the membrane C. Conn’s disease
of typical cardiomyocytes permitted an D. Diabetes mellitus
increase in: E. Essential hypertension
A. Calcium ion entry 87. 2 days after labour a woman developed
B. Calcium ion exit shock along with DIC syndrome that
C. Potassium ion exit caused her death. Autopsy revealed
D. Potassium ion entry purulent endomyometritis, regional
E. Calcium and potassium ion exit purulent lymphangitis, lymphadenitis and
purulent thrombophlebitis. There were
83. According to the results of glucose also dystrophic alterations and interstitial
tolerance test a patient has no disorder inflammation of parenchymal organs. What
of carbohydrate tolerance. Despite that is the most likely diagnosis?
glucose is detected in the patients’s urine (5
mmol/l). The patient has been diagnosed wi- A. Septicemia
th renal diabetes. What renal changes cause B. Syphilis
glucosuria in this case? C. Tuberculosis of genital organs
D. Chorioadenoma destruens
A. Decreased activity of glucose reabsorpti- E. Hydatid mole
on enzymes
B. Increased activity of glucose reabsorption 88. In case of alkaptonuria, homogentisic
enzymes acid is excreted in urine in large amounts.
C. Exceeded glucose reabsorption threshold The development of this disease is associ-
D. Increased glucose secretion ated with metabolic disorder of the followi-
E. Increased glucose filtration ng amino acid:
84. Alveolar space of acinus was invaded by A. Tyrosine
bacteria that interacted with the surfactant. B. Phenylalanine
This led to the activation of the cells that C. Alanine
are localized in the alveolar walls and on the D. Methionine
surface. Name these cells: E. Asparagine
A. Alveolar macrophages 89. When blood circulation in the damaged
B. Alveolocytes type I tissue is restored, lactate accumulation stops
C. Endothelial cells and glucose consumption decelerates. These
D. Clara cells metabolic changes are caused by activation
E. Alveolocytes type II of the following process:
85. Parents of a 5-year-old boy report him A. Aerobic glycolysis
to have frequent colds that develop into B. Anaerobic glycolysis
pneumonias, presence of purulent rashes C. Lipolysis
on the skin. Laboratory tests have revealed D. Gluconeogenesis
the following: absence of immunoglobuli- E. Glycogen biosynthesis
ns of any type, and naked cells are absent
from the lymph nodes punctate. What kind 90. A doctor examined a patient, studied the
of immune disorder is it? blood analyses, and reached a conclusion,
that peripheral immunogenesis organs are
A. X-linked hypogammaglobulinemia affected. What organs are the most likely to
(Bruton type agammaglobulinemia) be affected?
B. Autosomal recessive agammaglobuli-
naemia (Swiss type) A. Tonsils
C. Hypoplastic anemia B. Thymus
D. Agranulocytosis C. Kidneys
E. Louis-Barr syndrome D. Red bone marrow
E. Yellow bone marrow
86. Examination of a 42-year-old patient
revealed a tumour of adenohypophysis. 91. A doctor asked a patient to make a deep
exhalation after a normal inhalation. What
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
muscles contract during such exhalation?
A. Abdominal muscles
B. External intercostal muscles
C. Diaphragm
D. Trapezius muscles
E. Pectoral muscles
92. 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?
A. Impaired synthesis of calcitriol
B. Increased excretion of calcium
C. Hyperfunction of parathyroid glands
D. Hypofunction of parathyroid glands
E. Lack of calcium in food
93. In a cat with decerebrate rigidity the
muscle tone is to be decreased. This can be
achieved by:
A. Destruction of the vestibular nuclei of
Deiters
B. Stimulation of the otolithic vestibular
receptors
C. Stimulation of the vestibular nuclei of
Deiters
D. Stimulation of the vestibulocochlear nerve
E. Stimulation of the ampullar vestibular
receptors
94. Autopsy of a 5-year-old child revealed
in the area of vermis of cerebellum a soft
greyish-pink node 2 cm in diameter with
blurred margins and areas of haemorrhage.
Histologically this tumour consisted of
atypical monomorphous small round cells
with large polymorphous nuclei. What
tumour is it?
A. Medulloblastoma
B. Meningioma
C. Glioblastoma
D. Astrocytoma
E. Oligodendroglioma
95. Surface with an intact toad on it was
inclined to the right. Tone of extensor
muscles became reflectory higher due to the
activation of the following receptors:
A. Vestibuloreceptors of utricle and saccule
B. Vestibuloreceptors of semicircular ducts
C. Mechanoreceptors of foot skin
D. Photoreceptors of retina
E. Proprioreceptors
96. A patient with high-titer antinuclear
antibodies died from progressing renal
impairment. Autopsy revealed mesangi-
oproliferative glomerulonephritis and
abacterial polypous endocarditis. Periarteri-
al bulbar sclerosis was detected in spleen
and productive proliferative vasculitis in
10
skin. What is the most likely diagnosis?
A. Systemic lupus erythematosus
B. Nephrotic syndrome
C. Rheumatism
D. Dermatomyositis
E. Periarteritis nodosa
97. When studying the signs of pulmonary
ventilation, reduction of forced expiratory
volume has been detected. What is the li-
kely cause of this phenomenon?
A. Obstructive pulmonary disease
B. Increase of respiratory volume
C. Increase of inspiratory reserve volume
D. Increase of pulmonary residual volume
E. Increase of functional residual lung
capacity
98. A specimen of a parenchymal organ
shows poorly delineated hexagonal lobules
surrounding a central vein, and the
interlobular connective tissue contains
embedded triads (an artery, a vein and an
excretory duct). What organ is it?
A. Liver
B. Pancreas
C. Thymus
D. Spleen
E. Thyroid
99. 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?
A. Inferior part of precentral gyrus
B. Superior part of precentral gyrus
C. Supramarginal gyrus
D. Superior parietal lobule
E. Angular gyrus
100. During intravenous saline transfusion
a patient’s condition deteriorated drasti-
cally, and the patient died from asphyxiati-
on. Autopsy revealed acute venous congesti-
on of internal organs with sharp right heart
dilatation. When the right ventricle was
punctured underwater, the bubbles escaped.
What pathological process occurred in the
patient?
A. Air embolism
B. Gaseous embolism
C. Adipose embolism
D. Tissue embolism
E. Thromboembolism
101. Diseases of respiratory system and ci-
rculatory disorders impair the transport of
oxygen, thus causing hypoxia. Under these
conditions the energy metabolism is carri-
ed out by anaerobic glycolysis. As a result,
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
the following substance is generated and
accumulated in blood:
A. Lactic acid
B. Pyruvic acid
C. Glutamic acid
D. Citric acid
E. Fumaric acid
102. Examination of a 6-month-old child
revealed a delay in closure of the occipital
fontanelle. When should it normally close?
A. Before 3 months
B. Before the child is born
C. Before 6 months
D. Before the end of the first year of life
E. Before the end of the second year of life
103. Sex chromosomes of a woman didn’t
separate and move to the opposite poles
of a cell during gametogenesis (meiosis).
The ovum was impregnated with a normal
spermatozoon. Which chromosomal disease
can be found in her child?
A. Turner’s syndrome
B. Down’s syndrome
C. Patau’s syndrome
D. Edwards’ syndrome
E. Cat cry syndrome
104. A patient was prescribed loratadine to
treat allergic cheilitis. What is the mechani-
sm of action of this drug?
A. Blockade of H1 -histamine receptors
B. Blockade of adrenergic receptors
C. Increases activty of monoamine oxidase
D. Suppresses activity of N a+ /K + -ATPase
E. Suppresses activity of choline esterase
105. During introduction of local anesthesia
a patient has gone into anaphylactic shock.
What drug must be administered to the pati-
ent?
A. Epinephrine hydrochloride
B. Diazepam
C. Atropine sulfate
D. Propranolol
E. Nitroglycerin
106. A patient has been diagnosed wi-
th influenza. His condition drastically
worsened after taking antipyretic drugs. He
is unconscious, AP is 80/50 mm Hg, Ps is
140/m, body temperature dropped down to
35, 8o C . What complication developed in
this patient?
A. Collapse
B. Hyperthermia
C. Hypovolemia
D. Acidosis
E. Alkalosis
11
107. An alcoholic has alcoholic psychosis
with evident psychomotor agitation. What
neuroleptic drug should be administered for
emergency aid?
A. Aminazine
B. Diazepam
C. Sodium bromide
D. Reserpine
E. Halothane
108. During blood transfusion a patient
has developed intravascular erythrocyte
hemolysis. What kind of hypersensitivity
does the patient have?
A. II type (antibody-dependent)
B. I type (anaphylactic)
C. III type (immune complex)
D. IV type (cellular cytotoxicity)
E. IV type (granulomatosis)
109. In the course of an experiment
thalamocortical tracts of an animal were cut.
What type of sensory perception remained
intact?
A. Olfactory
B. Auditory
C. Exteroreceptive
D. Visual
E. Nociceptive
110. A 4-year-old child presents with
general weakness, sore throat and deglutiti-
ve problem. After his examination a doctor
suspected diphtheria and sent the material
to a bacteriological laboratory. To determine
the diphtheria causative agent the material
should be inoculated into the following di-
fferential diagnostic medium:
A. Blood tellurite agar
B. Endo’s agar
C. Ploskyrev’s agar
D. Sabouraud’s agar
E. Levenshtein-Yessen agar
111. When treating a patient with
chronic cardiac failure a doctor detected
bradycardia and deterioration of the pati-
ent’s general state. Such condition is caused
by cumulative effect of a drug. Which drug
of those listed below has cumulative action?
A. Digoxin
B. Diphenhydramine (Dimedrol)
C. Hydrochlorothiazide
D. Isosorbide
E. Retinol acetate
112. A doctor was addressed by a 30-year-
old man. There is a probability of the patient
being HIV-positive. To clarify the diagnosis
the doctor proposed to perform polymerase
chain reaction. The basic process in this kind
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 12

of investigation is: A. Low level of carnitine

B. Impaired phospholipid synthesis
A. Gene amplification C. Excessive consumption of fatty foods
B. Transcription D. Choline deficiency
C. Genetic recombination E. Lack of carbohydrates in the diet
D. Genomic mutation
E. Chromosome mutation 118. During ventricular systole the cardiac
muscle does not respond to additional sti-
113. Due to the use of poor-quality measles mulation because it is in the phase of:
vaccine for preventive vaccination, a 1-
year-old child developed an autoimmune A. Absolute refractoriness
renal injury. The urine was found to contain B. Relational refractoriness
macromolecular proteins. What process of C. Hyperexcitability
urine formation was disturbed? D. Subnormal excitability
E. There is no correct answer
A. Filtration
B. Reabsorption 119. A patient is diagnosed with acute
C. Secretion morphine hydrochloride intoxication.
D. Reabsorption and secretion Prescribe the oxidizing agent for gastric
E. Secretion and filtration lavage:
114. A 26-year-old female patient with A. Potassium permanganate
bronchitis has been administered a broad B. Chloramine
spectrum antibiotic as a causal treatment C. Sulfocamphocainum (Procaine +
drug. Specify this drug: Sulfocamphoric acid)
D. Cerigel
A. Doxycycline E. Chlorhexidine (bi)gluconate
B. Interferon
C. BCG vaccine 120. During cell division DNA replication
D. Ambroxol occurs after a signal is received from the
E. Dexamethasone cytoplasm, then a certain portion of the
DNA helix unwinds and splits into two indi-
115. A 65-year-old man suddenly lost vision vidual strains. What enzyme facilitates this
in one eye due to the retinal detachment. process?
The patient underwent enucleation. Hi-
stological examination of the removed eye A. Helicase
retina and choroid revealed clusters of atypi- B. RNA polymerase
cal cells with marked polymorphism of cells C. Ligase
and nuclei, with a moderate number of mi- D. Restrictase
toses including the pathological ones. The E. DNA polymerase
cell cytoplasm and intercellular medium
contained brown pigment resulting in posi- 121. A patient has been given atropine
tive DOPA reaction. Perls’ reaction was sulfate for rapid relief of spastic colon
negative. What is the most likely diagnosis? symptoms. The use of this drug is contrai-
ndicated during the followng disease:
A. Melanoma
B. Pigmented mole A. Glaucoma
C. Hemorrhage B. Bronchial asthma
D. Cysticercosis C. Bradycardia
E. Wilson’s disease D. Hypotension
E. Gastric ulcer
116. During determining the blood group
according to the AB0 system with salt soluti- 122. As an example of specific human parasi-
ons of monoclonal antibodies agglutination tes one can name Plasmodium falciparum,
did not occur with any of the solutions. What human pinworm and some others. The
blood group is it? source of parasite invasion in these cases is
always a human. Such specific human parasi-
A. 0 (I) tes cause the diseases that are called:
B. А (II)
C. В (III) A. Anthroponoses
B. Zoonoses
D. АВ (IV) C. Anthropozoonoses
E. - D. Infections
117. One of the factors that cause obesity is E. Multifactorial diseases
inhibition of fatty acids oxidation due to: 123. In the course of an experiment there
has been increase in nerve conduction
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
velocity. This may be caused by increase in
concentration of the following ions that are
present in the solution around the cell:
A. N a+
B. K + and Cl−
C. K + and N a+
D. Ca2+ and Cl−
E. Ca2+
124. An HIV-positive patient’s cause of
death is acute pulmonary insufficiency
resulting from pneumonia. Pathohistological
investigation of lungs has revealed intersti-
tial pneumonia, alveolocyte desquamati-
on and methamorphoses: alveolocyte
enlargement, large intranuclear inclusi-
ons surrounded by lightly-coloured areas.
Transformed cells resemble owl’s eye. Name
the causative agent of pneumonia:
A. Cytomegalovirus
B. Pneumococcus
C. Influenza virus
D. Candida fungi
E. Toxoplasma
125. The organisms to be identified have a
nucleus surrounded by a nuclear membrane.
Genetic material is concentrated predomi-
nantly in the chromosomes that consist
of DNA strands and protein molecules.
These cells divide mitotically. Identify these
organisms:
A. Eukaryotes
B. Bacteriophages
C. Prokaryotes
D. Viruses
E. Bacteria
126. A 2-year-old boy is diagnosed wi-
th Down syndrome. What chromosomal
changes may be the cause of this disease?
A. Trisomy 21
B. Trisomy 13
C. Trisomy X
D. Trisomy 18
E. Monosomy X
127. After a road accident a victim has
tachycardia, arterial blood pressure 130/90
mm Hg, tachypnoe, the skin is pale and
dry, excitation of central nervous system is
observed. What shock stage is the patient
most likely in?
A. Erectile
B. Terminal
C. Torpid
D. Preshock (compensation stage)
E. Agony
128. As a result of a mechanical injury an
over 10 cm long portion of a peripheral
13
nerve was damaged. This caused an impai-
rment of the upper limb activity. The patient
was offered nerve transplantation. What gli-
al cells will participate in regeneration and
provide the trophism of the injured limb?
A. Schwann cells
B. Fibrous cells
C. Protoplasmic cells
D. Microglia
E. Ependymal cells
129. A 47-year-old man developed intesti-
nal colic against the background of essential
hypertension. In this situation it would be
most efficient to arrest the colic by admini-
stering drugs of the following group:
A. Myotropic antispasmodics
B. Anticholinesterase agents
C. Sympathomimetics
D. M-cholinomimetics
E. Adrenomimetics
130. Microscopy of a female patient’s swabs
made from vaginal secretion revealed gram-
negative bean-shaped diplococci. What
provisional diagnosis can be made?
A. Gonorrhoea
B. Syphilis
C. Clamidiosis
D. Mycoplasmosis
E. Toxoplasmosis
131. A 54-year-old woman was brought to a
casualty department after a car accident. A
traumatologist diagnosed her with multiple
fractures of the lower extremities. What ki-
nd of embolism is most likely to develop in
this case?
A. Adipose
B. Tissue
C. Thromboembolism
D. Gaseous
E. Air
132. A therapeutist has an appointment
with a 40-year-old patient complaining of
recurrent pain attacks in his hallux joints
and their swelling. Urine analysis revealed
its marked acidity and pink colour. What
substances can cause such changes in the
urine?
A. Uric acid salt
B. Chlorides
C. Ammonium salts
D. Calcium phosphate
E. Magnesium sulfate
133. A 30-year-old man with diabetes
mellitus type I was hospitalised. The
patient is comatose. Laboratory tests
revealed hyperglycemia and ketonemia.
What metabolic disorder can be detected
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 14

in this patient? following protein:

A. Metabolic acidosis A. α1 -proteinase inhibitor
B. Metabolic alkalosis B. α2 -macroglobulin
C. Respiratory acidosis C. Cryoglobulin
D. Respiratory alkalosis D. Haptoglobin
E. Normal acid-base balance E. Transferrin
134. A 15-year-old patient has fasting 139. A patient, who has been suffering for
plasma glucose level 4,8 mmol/l, one hour a long time from intestine disbacteriosis,
after glucose challenge it becomes 9,0 has increased hemorrhaging caused by di-
mmol/l, in 2 hours it is 7,0 mmol/l, in 3 sruption of posttranslational modification of
hours it is 4,8 mmol/l. Such parameters are blood-coagulation factors II, VII, IХ, and Х
characteristic of: in the liver. What vitamin deficiency is the
cause of this condition?
A. Subclinical diabetes mellitus
B. Diabetes mellitus type 1 A. К
C. Diabetes mellitus type 2 B. 12
D. Healthy person C. 9
E. Cushing’s disease D. С
E. Р
135. A patient has undergone surgical
removal of a cavitary liver lesion 2 cm 140. During a surgery for femoral hernia a
in diameter. It was revealed that the surgeon operates within the boundaries of
cavity wall was formed by dense fibrous femoral trigone. What structure makes up
connective tissue; the cavity contained its upper margin?
murky thick yellowish-green fluid with an
unpleasant odor. Microscopically the fluid A. Lig. inguinale
consisted mainly of polymorphonuclear B. Arcus iliopectineus
leukocytes. What pathological process are C. Lig. lacunare
these morphological changes typical for? D. Lig. pectinale
E. Fascia lata
A. Chronic abscess
B. Acute abscess 141. An obstetrician-gynecologist measures
C. Phlegmon pelvis size of a pregnant woman. A caliper
D. Empyema was used to measure the distance between
E. - the two iliac crests. What measurement of
large pelvis was made?
136. A patient consulted a physician about
chest pain, cough, fever. Roentgenography A. Distantia cristarum
of lungs revealed eosinophilic infiltrates B. Distantia throchanterica
which were found to contain the larvae. C. Distantia spinarum
What kind of helminthiasis are these D. Conjugata vera
presentations typical for? E. Conjugata anatomica

A. Ascariasis 142. A patient has arterial hypertension.

B. Echinococcosis What long-acting drug from the group of
C. Fascioliasis calcium channel blockers should be prescri-
D. Cysticercosis bed?
E. Trichinosis
A. Amlodipine
137. During appendectomy a patient had B. Octadine
the a. appendicularis ligated. This vessel C. Pyrroxanum
branches from the following artery: D. Atenolol
E. Reserpine
A. A. Ileocolica
B. A. colica dextra 143. A patient has been diagnosed
C. A. colica media with URTI. Blood serum contains
D. A. sigmoidea immunoglobulin M. What stage of infecti-
E. A. mesenterica inferior on is it?
138. A 28-year-old patient undergoing A. Acute
treatment in a pulmonological department B. Prodromal
has been diagnosed with pulmonary C. Incubation
emphysema caused by splitting of alveolar D. Reconvalescence
septum by tissular tripsin. The disease is E. Carriage
caused by the congenital deficiency of the
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 15

144. A 43-year-old patient suffers from acute A. Sphygmography

pancreatitis with disrupted common bile B. Plethysmography
duct patency. What condition can develop C. Rheography
in this case? D. Myography
E. Phlebography
A. Mechanical jaundice
B. Hemolytic jaundice 150. A patient has developed paroxysmal
C. Hepatocellular jaundice ventricular tachycardia against the
D. Hepatic coma background of cardiac infarction. What anti-
E. Portal hypertension arrhythmic drug should be chosen to avoid
lowering cardiac output?
145. A patient has a tumor of the eyesocket
tissues behind the eyeball. Disruption of A. Lidocaine hydrochloride
accomodation and pupil constriction is B. Procainamide
observed. What anatomical structure is C. Verapamil
damaged? D. Propranolol
E. Potassium chloride
A. Ganglion ciliare
B. N. nasociliaris 151. Electrocardiogram of a young man
C. N. lacrimalis reveals deviation of his electrical axis of
D. N. opticus heart to the left. This phenomenon can be
E. N. trochlearis caused by:
146. Lymphocytes and other cells of our A. Hypersthenic body type
body synthesize universal antiviral agents B. Asthenic body type
as a response to viral invasion. Name these C. Dilation of the right atrium
protein factors: D. Dilation of the right ventricle
E. Dilation of the left atrium
A. Interferon
B. Interleukin - 2 152. A 6-year-old child suffers from delayed
C. Cytokines growth, disrupted ossification processes,
D. Interleukin - 4 decalcification of the teeth. What can be the
E. Tumor necrosis factor cause?
147. A patient consulted a dentist about A. Vitamin D deficiency
restricted mouth opening (trismus). B. Decreased glucagon production
Anamnesis states a stab wound of the lower C. Insulin deficiency
extremity. What infection may cause these D. Hyperthyroidism
symptoms? E. Vitamin C deficiency

A. Tetanus 153. A 30-year-old patient’s blood test

B. Brucellosis
C. Whooping cough
D. Wound anaerobic infection
E. Tularemia
148. A patient has damaged spinal cord whi-
te matter in the middle area of the posteri-
or white column, disrupted propriocepti-
ve sensibility of the lower limb joints and
muscles. What fibers are affected?
A. Fasciculus gracilis
B. Tr. spinothalamicus lateralis
C. Tr. spinocerebellaris anterior
D. Tr. spinocerebellaris posterior
E. Fasciculus cuneatus
149. 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?
revealed the following: erythrocyte count
is 6 · 1012 /l, hemoglobin is 10,55ммоль/l.
Vaquez’s disease was diagnosed. Name the
leading part of pathogenesis:
A. Neoplastic erythroid hyperplasia
B. Iron-deficiency
C. B12 -deficiency
D. Hypoxia
E. Acidosis
154. A 25-year-old patient complains of
increasing pain in his leg muscles occurri-
ng during walking and forcing him to make
frequent stops. Objectively: skin of legs
is pale, no hair-covering, toenails are wi-
th trophic changes, no pulsation of pedal
arteries. The most probable cause of these
changes is:
A. Ischemia
B. Venous hyperemia
C. Arterial hyperemia
D. -
E. Embolism
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 16

155. This year influenza epidemic is A. Low-density lipoproteins

characterised by patients’ body temperature B. High-density lipoproteins
varying from 36, 9o C to 37, 9o C . Such fever C. Chylomicrons
is called: D. Very low-density lipoproteins
E. Middle-density lipoproteins
A. Subfebrile
B. High 161. Obesity is a common disease. The
C. Hyperpyretic aim of its treatment is to lower content
D. Apyretic of neutral fats in the body. What hormon-
E. Moderate sensitive enzyme is the most important for
intracellular lipolysis?
156. A woman complains of visual impai-
rment. Examination revealed obesity in the A. Triacylglycerol lipase
patient and her fasting plasma glucose level B. Protein kinase
is hyperglycemic. What diabetes complicati- C. Adenylate kinase
on can cause visual impairment/blindness? D. Diacylglycerol lipase
E. Monoacylglycerol lipase
A. Microangiopathy
B. Macroangiopathy 162. A 40-year-old woman was diagnosed
C. Atherosclerosis with glomerulonephritis based on her cli-
D. Neuropathy nical symptoms and the results of urine
E. Glomerulopathy analysis. Anamnesis states chronic tonsilli-
tis. What microorganisms are the most likely
157. Prolonged treatment of hypothyroidism cause for her kidney damage?
has caused general dystrophy, dental cari-
es, tachycardia, tremor of extremities. What A. Streptococci
drug is the cause of these side effects? B. Staphylococci
C. Escherichia
A. L-thyroxin D. Mycoplasma
B. Humulin (Human insulin) E. Meningococci
C. Parathyreoidinum
D. Thyrocalcitonin 163. A man is suffering from diarrhea. In
E. Prednisolone summer he spent his vacation in the south
at the sea coast. Bacteria with the following
158. A 3-year-old child has eaten some properties were detected in his feces: gram-
strawberries. Soon he developed a rash negative curved mobile monotrichous baci-
and itching. What was found in the child’s lli that do not produce spores or capsules.
leukogram? They are undemanding to nutrient medium
but require alkaline reaction (рН 8,5-09,5).
A. Eosinophilia Described are the agents of the following
B. Hypolymphemia enteric infection:
C. Neutrophilic leukocytosis
D. Monocytosis A. Cholera
E. Lymphocytosis B. Shigellosis
C. Typhoid fever
159. A patient has been found to have a D. Colienteritis
marked dilatation of the saphenous veins E. Pseudotuberculosis
in the region of anterior abdominal wall
around the navel. This is symptomatic of 164. A patient is diagnosed with chronic
pressure increase in the following vessel: atrophic gastritis attended by deficiency of
Castle’s intrinsic factor. What type of anemia
A. V. portae hepatis does the patient have?
B. V. cava superior
C. V. cava inferior A. B12 -deficiency anemia
D. V. mesenterica inferior B. Iron refractory anemia
E. V. mesenterica superior C. Hemolytic anemia
D. Iron-deficiency anemia
160. Cholesterol content in blood serum E. Protein-deficiency anemia
of a 12-year-old boy is 25 mmol/l.
Anamnesis states hereditary familial 165. A pregnant woman was detected wi-
hypercholesterolemia caused by synthesis th IgM to rubella virus. An obstetrician-
disruption of receptor-related proteins for: gynecologist recommended therapeutic
abortion due to the high risk of teratogenic
affection of the fetus. Detection of IgM was
of great importance as it is these specific
immunoglobulins that:
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк 17

A. Hemolytic anemia
A. Indicate recent infection B. Pernicious anemia
B. Penetrate placental barrier C. Megaloblastic anemia
C. Have the largest molecular weight D. Sicklemia
D. Are associated with anaphylactic reacti- E. Iron-deficiency anemia
ons
E. Are the main factor of antiviral protection 171. In winter a 3-year-old child has
sharp rise of body temperature up to
166. A patient is diagnosed with cardi- 40o C . Hemorrhagic rash is observed on
ac infarction. Blood test for cardiospecific the skin and mucosa. Bean-shaped gram-
enzymes activity was performed. Which of negative microorganisms situated in pairs
the enzymes has three isoforms? are detected in the blood. What provisional
diagnosis can be made?
A. Creatine kinase
B. Lactate dehydrogenase A. Meningococcosis
C. Aspartate transaminase B. Gonorrhea
D. Alanine transaminase C. Scarlet fever
E. Pyruvate kinase D. Influenza
E. Diphtheria
167. A 50-year-old man, who has been
suffering from chronic hepatic failure for 172. Microelectrode analysis of nerve fi-
several years, has developed ascites. What ber biolectrical activity revealed, that its
is the main mechanism of this disorder membrane potential equals 90 mV. Its ini-
development? tial rest potential was 85 mV. What process
occurs in this case?
A. Increased pressure in portal vein system
B. Decrease of albumin and globulin A. Hyperpolarization
synthesis in liver B. Depolarization
C. Increased content of low-density and very C. Repolarization
low-density lipoproteins in blood D. Overshoot
D. Neurotoxins appearing in blood E. Supernormality
E. Increase of blood oncotic pressure
173. Parkinson’s disease is caused by di-
168. A 30-year-old man has sustained an sruption of dopamine synthesis. What brain
injury to his thorax in a traffic incident, whi- structure synthesizes this neurotransmitter?
ch caused disruption of his external respi-
ration. What type of ventilatory difficulty A. Substantia nigra
can be observed in the given case? B. Globus pallidus
C. Corpora quadrigemina
A. Restrictive extrapulmonary ventilatory D. Red nucleus
impairment E. Hypothalamus
B. Restrictive pulmonary ventilatory impai-
rment 174. Determining a patient’s blood group wi-
C. Obstructive ventilatory impairment th monoclonal test-reagents revealed positi-
D. Impaired ventilation regulation dysfuncti- ve agglutination reaction to anti-A and anti-
on B reagents, and negative reaction to anti-D.
E. Cardiovascular collapse What blood group does this patient have?
169. A 53-year-old man suffering from di- A. IV (АВ) Rh−
abetes mellitus has developed a painful B. II (А) Rh+
conical induration, bluish-red with yellow C. III (В) Rh−
center, on the skin of his neck. Such changes D. IV (АВ) Rh+
are characteristic of: E. I (0) Rh+
A. Furuncle 175. A patient visited a dentist to extract a
B. Abscess tooth. After the tooth had been extracted,
C. Carbuncle bleeding from the tooth socket continued
D. Phlegmon for 15 minutes. Anamnesis states that the
E. Empyema patient suffers from active chronic hepatitis.
What phenomenon can extend the time of
170. Biochemical analysis of an infant’s hemorrhage?
erythrocytes revealed evident glutathione
peroxidase deficiency and low concentrati-
on of reduced glutathione. What pathologi-
cal condition can develop in this infant?
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
A. Decrease of fibrinogen content in blood
B. Thrombocytopenia
C. Hypocalcemia
D. Increased activity of anticoagulation
system
E. Decrease of albumine content in blood
176. Name the halogen-containing antiseptic
with fungicidal properties, which is used to
treat dermatomycosis:
A. Iodine solution
B. Formalin solution
C. Methylene blue
D. Brilliant green
E. Boric acid solution
177. Due to severe pain syndrome a patient
was prescribed a narcotic analgesic. Name
this drug:
A. Morphine
B. Metamizole (Analgin)
C. Nimesulide
D. Dimethyl sulfoxide
E. Indometacin
178. During pathomorphological kidney
investigation of a patient, who for a long
time had been suffering from osteomyeli-
tis and died from progressing renal fai-
lure, the following was revealed: deposi-
ts of homogeneous eosinophilic masses
in glomerular mesangium, arterial and
arteriolar walls, and stroma, which became
red when stained with Congo red. What
pathological process is this?
A. Amyloidosis
B. Mucoid swelling
C. Calcinosis
D. Carbohydrate degeneration
E. Hyalinosis
179. A microslide presents a tissue with
spherical cells, each of them containing a
large fat drop covered with thin cytoplasm
layer in its center. Nucleus is compressed
and situated at the cell periphery. What ti-
ssue is it?
A. White adipose tissue
B. Brown adipose tissue
C. Mucous tissue
D. Pigmented tissue
E. Reticular tissue
180. To treat rheumatoid arthritis a
65-year-old woman was prescribed an
immunosuppressive hormonal drug as a part
of her complex therapy. Name this drug:
18
A. Prednisolone
B. Thymus cytomedins (Thymalin)
C. Chloropyramine (Suprastin)
D. Riboflavin
E. Fercovenum
181. An experiment was aimed at testing
flexor reflex in a spinal frog, which was
initiated by simultaneous stimulation with
isolated pre-threshold electrical impulses.
The frequency of those impulses was such,
that the reflex occurred. What process in the
nerve centers can be observed during this
experiment?
A. Temporal summation
B. Spatial summation
C. Presynaptic summation
D. Postsynaptic summation
E. Threshold summation
182. A patient diagnosed with acute
dysentery has been treated for 3 days in an
infectious diseases hospital. On admission
there were complaints of high temperature,
stomachache and fluid excrements with
mucus as often as 8-10 times a day. What
sample should be taken for analysis?
A. Feces
B. Urine
C. Bile
D. Liquor
E. Blood
183. An 18-year-old woman has body di-
sproportion, wing-like folds on the skin of
her neck, underdeveloped ovaries, nuclei
of her buccal epithelium cells have no Barr
bodies. Dermatoglyphics method revealed
that her adt angle is 66o . What provisional
diagnosis can be made in this case?
A. Turner’s syndrome
B. Cri du chat (cat cry) syndrome
C. Kleinfelter’s syndrome
D. Patau’s syndrome
E. Edwards’ syndrome
184. A 27-year-old patient with injury to
the neck has lost approximately 30% of
the blood volume. The patient’s condition is
severe: blood pressure is 60/40 mm Hg, heart
rate is 140/min., respiratory rate is 30/min.,
conscious. Characterize the condition of the
patient’s circulatory system:
A. Hypovolemic shock
B. Cardiogenic shock
C. Collapse
D. Coma
E. Arterial hypertension
185. A soldier with explosion-caused trauma
was delivered to a hospital. Examinati-
on revealed his tympanic membrane to be
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
intact. What defense reflex prevented the
tympanic membrane from rupturing?
A. Contraction of m. tensor tympani
B. Relaxation of m. tensor tympani
C. Contraction of m. auricularis arterior
D. Relaxation of m. auricularis arterior
E. Relaxation of m. stapedins
186. A person with the fourth blood group
(genotype IAIB) has in erythrocytes both
antigen A controlled by allele IA and
antigen B controlled by allele IB. This
phenomenon is an example of the following
gene interation:
A. Codominance
B. Complementarity
C. Semidominance
D. Polymery
E. Epistasis
187. During narcosis a patient developed a
risk of cerebral edema. What drug should be
administered in this case?
A. Furosemide
B. Dopamine
C. Phenazepam
D. Triamterene
E. Sodium bromide
188. During surgery performed in abdomi-
nal cavity a surgeon located ligament of li-
ver stretching from anterior abdominal wall
(navel) to inferior surface of liver. What li-
gament is it?
A. Round ligament of the liver
B. Falciform ligament of the liver
C. Coronary ligament of the liver
D. Venous ligament of the liver
E. Triangular ligament of the liver
189. A 9-year-old boy has acute onset of di-
sease: sore throat, body temperature rise up
to 39, 5o C ; on the second day diffuse skin
rash was detected all over his skin exept for
nasolabial triangle. On examination of oral
cavity: crimson tongue, "flaming pharynx",
necrotic tonsillitis. What diagnosis is the
most likely?
A. Scarlet fever
B. Measles
C. Diphtheria
D. Influenza
E. Meningococcemia
190. A 49-year-old man complains of
pain in his metatarsophalangeal joints
and joint deformation. In blood hyperuri-
cemy can be observed. X-ray has revealed
metatarsophalangeal joint space narrowi-
ng, erosion, periarticular calcification of
the both joints, osteoporosis. Microscopy
19
has revealed inflammatory granulomatous
reaction surrounding necrotizing masses in
the area of the first metatarsophalangeal joi-
nt. Choose the most likely diagnosis:
A. Gout (podagra)
B. Pyrophosphate arthropathy
C. Rheumatoid arthritis
D. Hyperparathyroidism
E. Urolithiasis
191. Granulomas containing lymphocytes
and macrophages were detected during
analysis of skin biopsy material. Among
macrophages there are large cells with fat
inclusions, which contain microorganisms
in spheric packages (Virchow’s cells). The
following disease is based on the described
type of hypersensitivity:
A. Leprosy
B. Syphilis
C. Tuberculosis
D. Rhinoscleroma
E. Epidemic typhus
192. A patient with suspected necrosis of
the upper abdominal cavity organs was deli-
vered to a surgical department. This condi-
tion is associated with acute circulatory di-
sturbance of the following vessel:
A. Tuncus coeliacus
B. A. mesenterica inferior
C. A. mesenterica superior
D. A. iliaca communis
E. A. renalis
193. Name the drug that inhibits excretory
function of pancreas during treatment of
acute pancreatitis:
A. Contrykal (Aprotinin)
B. Allochol
C. Раnzynorm
D. Pancreatin (Mezym forte)
E. Festal
194. An 18-year-old patient has developed
candidiasis after the case of pneumonia
treated with β -lactam antibiotic. What anti-
mycotic agent should be prescribed?
A. Fluconazole
B. Streptomycin
C. Ampicillin
D. Phthalylsulfathiazole
E. Trimethoprim/sulfamethoxazole (Bi-
septol)
195. During autopsy of a 9-month-old girl’s
body, who died due to severe pneumonia
complicated with sepsis, lack of thymus is
observed. In the lymph nodes the lymphoid
follicles and cortical substance are absent;
follicles of spleen are reduced in size with
 Крок 1 Medicine (англомовний варiант, iноземнi студенти) 2015 рiк
no light zones and plasma cells. What is the
cause of such structural changes?
A. Thymus agenesis
B. Accidental involution of thymus
C. Thymus hypoplasia
D. Thymus atrophy
E. Thymus aplasia
196. A patient with femoral neck fracture,
who for a long time had to remain in bed
in a forced (supine) position, has developed
dark-brown lesions along the backbone; soft
tissues are swollen, in the areas of macerati-
on there is a foul-smelling liquid. Name the
clinicopathologic type of necrosis:
A. Bedsore
B. Infarction
C. Sequestrum
D. Coagulation necrosis
E. Dry gangrene
197. A woman poisoned with unknown
substance was hospitalised in a toxicologi-
cal department. What group of drugs can
be administered to decrease absorption and
introduction of the poison to her body?
A. Adsorbents
B. Neuroleptics
C. Antioxidants
D. Organic nitrates
E. Cholinesterase inhibitors
20
198. A patient after disrupted cerebral ci-
rculation has developed paralysis. Choose
the anticholinesterase drug to be prescribed
in this case:
A. Proserin
B. Cordiamin
C. Aceclidine
D. Methacin
E. Hexamethonium (Benzohexonium)
199. A 50-year-old woman is being treated
for shingles in a neurology unit. What reacti-
vated virus causes this disease?
A. Varicella zoster virus (chickenpox virus)
B. Herpes simplex virus type 1
C. Herpes simplex virus type 2
D. Measles virus
E. Cytomegalovirus
200. During examination of a patient a
doctor should use anatomical division of
anterior abdominal wall into regions for
more precise diagnostics. How many such
regions can abdomen be divided into?
A. 9
B. 8
C. 6
D. 5
E. 4
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
1. A 35-year-old man has been deli-
vered into a surgical ward with a suppurati-
ng wound in the neck, anterior to trachea
(previsceral space). If a surgical operation
is not performed urgently, there is a risk of
infection spreading to:
A. Thoracic cavity - anterior mediastinum
B. Thoracic cavity - middle mediastinum
C. Thoracic cavity - posterior mediastinum
D. Retrovisceral space
E. Interaponeurotic suprasternal space
2. Characteristic sign of glycogenosis is
muscle pain during physical work. Blood
examination usually reveals hypoglycemia.
This pathology is caused by congenital defi-
ciency of the following enzyme:
A. Glycogen phosphorylase
B. Glucose 6-phosphate dehydrogenase
C. α-amylase
D. γ -amylase
E. Lysosomal glycosidase
3. Histologic specimen of a kidney
demonstrates cells closely adjoined to the
renal corpuscle in the distal convoluted
tubule. Their basement membrane is
extremely thin and has no folds. These cells
sense the changes in sodium content of uri-
ne and influence renin secretion occurring
in juxtaglomerular cells. Name these cells:
A. Macula densa cells
B. Juxtaglomerular cells
C. Mesangial cells
D. Podocytes
E. Glomerular capillary endothelial cells
4. Bacteriological analysis of tap water has
resulted in the following: total bacterial
count in 1,0 ml of water is 80, coli index
is 3. What would be the conclusion?
A. The water is safe for consumption
B. The water quality is doubtful
C. The water quality is extremely doubtful
D. The water is polluted
E. The water is extremely polluted
5. The process of metabolism in the human
body produces active forms of oxygen,
− 11. A 15-year-old boy has been diagnosed
including superoxide anion radical 2.
This anion is inactivated by the following
enzyme:
A. Superoxide dismutase
B. Catalase
C. Peroxidase
D. Glutathione peroxidase
E. Glutathione reductase
6. What kind of muscle contraction occurs
in an upper limb during an attempt to lift a
load beyond one’s strength?
1
A. Isometric
B. Isotonic
C. Auxotonic
D. Phasic
E. Single
7. A patient suffers from high fever,
apnoea, pain in the thorax on the right.
Pleurocentesis yielded 700 ml of yellow-
green viscous liquid. Make the diagnosis:
A. Pleural empyema
B. Bronchial pneumonia
C. Serous pleurisy
D. Hemorrhagic pleurisy
E. Pleural carcinomatosis
8. A patient suffers from disrupted patency
of the airways at the level of small
and medium-sized bronchial tubes. What
changes of acid-base balance can occur in
the patient?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
E. Acid-base balance remains unchanged
9. Upon toxic damage of hepatic cells
resulting in disruption of liver function the
patient developed edemas. What changes of
blood plasma are the main cause of edema
development?
A. Decrease of albumin content
B. Increase of globulin conten
C. Decrease of fibrinogen conten
D. Increase of albumin conten
E. Decrease of globulin conten
10. A 6-year-old child with suspected acti-
ve tuberculous process has undergone di-
agnostic Mantoux test. What immunobi-
ological preparation was injected?
A. Tuberculin
B. BCG vaccine
C. DTP vaccine
D. Tularinum
E. Td vaccine
with acute viral hepatitis. What blood value
should be determined to confirm acute
affection of hepatic cells?
A. Aminotransferase activity (AST, ALT)
B. Unconjugated and conjugated bilirubin
content
C. Erythrocytes sedimentation rate (ESR)
D. Cholesterol content
E. Protein fraction content
12. A 53-year-old man is diagnosed with
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
Paget’s disease. Concentration of oxyproli-
ne in daily urine is sharply increased, which
primarily means intensified disintegration
of:
A. Collagen
B. Keratin
C. Albumin
D. Hemoglobin
E. Fibrinogen
13. When taking exams students often have
dry mouth. The mechanism that causes this
state results from the following reflexes:
A. Conditioned sympathetic
B. Unconditioned parasympathetic
C. Conditioned parasympathetic
D. Unconditioned sympathetic
E. Unconditioned peripheral
14. A patient has hoarseness of voice. Duri-
ng laryngoscopy a gray-white larynx tumor
with papillary surface has been detected.
Microscopic investigation has shown the
following: growth of connective tissue
covered with multilayer, strongly kerati-
nized pavement epithelium, no cellular
atypia. What is the most likely diagnosis?
A. Papilloma
B. Fibroma
C. Polyp
D. Angioma
E. Angiofibroma
15. During autopsy approximately 2,0 liters
of pus have been found in the abdominal
cavity of the body. Peritoneum is dull and
of grayish shade, serous tunic of intestines
has grayish-colored coating that is easily
removable. Specify the most likely type of
peritonitis in the patient:
A. Fibrinopurulent peritonitis
B. Hemorrhagic peritonitis
C. Serous peritonitis
D. Tuberculous peritonitis
E. -
16. Autopsy of a body revealed bone
marrow hyperplasia of tubular and flat
bones (pyoid marrow), splenomegaly (6 kg)
and hepatomegaly (5 kg), enlargement of
all lymph node groups. What disease are
the identified changes typical of?
A. Chronic myelogenous leukemia
B. Chronic lymphocytic leukemia
C. Multiple myeloma
D. Polycythemia vera
E. Hodgkin’s disease
17. A bacteriological laboratory has been
investigating a sample of homemade dri-
ed fish that was the cause of severe
2
food poisoning. Microscopy of the culture
inoculated in Kitt-Tarozzi medium revealed
microorganisms resembling a tennis racket.
What diagnosis can be made?
A. Botulism
B. Salmonellosis
C. Cholera
D. Dysentery
E. Typhoid fever
18. An infant has been diagnosed with mi-
crocephaly. Doctors suspect that this brain
disorder developed due to the fact that
the mother had been taking actinomycin D
during her pregnancy. What germinal layers
have been affected by this teratogen?
A. Ectoderm
B. Entoderm
C. Mesoderm
D. Entoderm and mesoderm
E. All germinal layers
19. A patient demonstrates sharp decrease
of pulmonary surfactant activity. This condi-
tion can result in:
A. Alveolar tendency to recede
B. Decreased airways resistance
C. Decresed work of expiratory muscles
D. Increased pulmonary ventilation
E. Hyperoxemia
20. A patient is diagnosed with diabetic
coma. Blood sugar is 18,44 mmol/l. What
glucose-regulating drug should be prescri-
bed in the given case?
A. Rapid-acting insulin
B. Intermediate-acting insulin
C. Long-acting insulin
D. Biguanide
E. Sulfonylurea derivative
21. Initial inoculation of water in 1%
peptone water resulted in growth of a thin
film on the medium surface in 6 hours.
Such cultural properties are characteristic
of causative agent of the following disesase:
A. Cholera
B. Plague
C. Tuberculosis
D. Dysentery
E. Pseudotuberculosis
22. An infant born prematurely 2 days ago
presents with yellow coloring of skin and
mucosa. Such a condition in the infant
is caused by temporary deficiency of the
following enzyme:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
A. UDP-glucuronyl transferase
B. Aminolevulinate synthase
C. Heme oxygenase
D. Heme synthetase
E. Biliverdine reductase
23. It has been determined that one of a
pesticide components is sodium arsenate
that blocks lipoic acid. Enzyme activity can
be impaired by this pesticide. Name this
enzyme:
A. Pyruvate dehydrogenase complex
B. Microsomal oxidation
C. Methemoglobin reductase
D. Glutathione peroxidase
E. Glutathione reductase
24. A 50-year-old woman diagnosed with
cardiac infarction has been delivered into
an intensive care ward. What enzyme will
be the most active during the first two days?
A. Aspartate aminotransferase
B. Alanine aminotransferase
C. Alanine aminopeptidase
D. LDH4
E. LDH5
25. Stool culture test of a 6-month-old
bottlefed baby revealed a strain of intesti-
nal rod-shaped bacteria of antigen structure
0-111. What diagnosis can be made?
A. Colienteritis
B. Gastroenteritis
C. Choleriform disease
D. Food poisoning
E. Dysentery-like disease
26. Parents of a sick 5-year-old girl vi-
sited a genetic consultation. Karyotype
investigation revealed 46 chromosomes.
One chromosome of the 15th pair was
abnormally long, having a part of the
chromosome belonging to the 21st pair
attached to it. What mutation occurred in
this girl?
A. Translocation
B. Deletion
C. Inversion
D. Deficiency
E. Duplication
27. A patient consulted a doctor with
complaints of dyspnea occurring after
physical exertion. Physical examination
revealed anemia, paraprotein was detected
among gamma globulins. What value should
be determined in the patient’s urine to
confirm the diagnosis of myeloma?
3
A. Bence Jones protein
B. Bilirubin
C. Hemoglobin
D. Ceruloplasmin
E. Antitrypsin
28. A patient complaining of dizziness, thi-
rst, difficult swallowing, and impaired visi-
on of close objects has addressed a doctor.
Objectively: respiratory rate is increased,
pupils are dilated, general agitation, talkati-
veness, though the speech is indistinct. BP is
110/70 mm Hg, heart rate is 110/min. Given
symptoms can indicate overdosage of the
following drug:
A. Atropine
B. Morphine
C. Ephedrine
D. Aminazine
E. Caffeine
29. A dry-cleaner’s worker has been found
to have hepatic steatosis. This pathology can
be caused by disruption of synthesis of the
following substance:
A. Phosphatidylcholine
B. Tristearin
C. Urea
D. Phosphatidic acid
E. Cholic acid
30. A 35-year-old man with peptic ulcer di-
sease has undergone antrectomy. After the
surgery secretion of the following gastro-
intestinal hormone will be disrupted the
most:
A. Gastrin
B. Histamine
C. Secretin
D. Cholecystokinin
E. Neurotensin
31. A 16-year-old adolescent is di-
agnosed with hereditary UDP (uridine di-
phosphate) glucuronyltransferase defici-
ency. Laboratory tests revealed hyperbi-
lirubinemia caused mostly by increased
blood content of the following substance:
A. Unconjugated bilirubin
B. Conjugated bilirubin
C. Urobilinogen
D. Stercobilinogen
E. Biliverdine
32. A 60-year-old patient with a long hi-
story of atherosclerosis and a previous
myocardial infarction developed an attack
of retrosternal pain. 3 days later the patient
was hospitalized and then died of progressi-
ve cardiovascular insufficiency. During
autopsy a white fibrous depressed area
about 3 cm in diameter with clear margi-
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
ns was found within the area of posterior
wall of the left ventricle and interventricular
septum. The dissector considered these
changes to be:
A. Focal cardiosclerosis
B. Myocardial ischemia
C. Myocardial infarction
D. Myocarditis
E. Myocardial degeneration
33. A patient with hypertension has
developed headache, tinnitus, vomiting, hi-
gh BP up to 220/160 mm Hg. On exami-
nation: facial asymmetry on the right, voli-
tional mobility is absent, increased tendon
reflexes and muscle tone of extremities on
the right. What motor disorder of nervous
system occurred in this case?
A. Hemiplegia
B. Paraplegia
C. Tetraplegia
D. Hyperkinesis
E. Monoplegia
34. A 7-year-old child in the state of allergic
shock caused by a bee sting has been
delivered into an emergency ward. High
concentration of histamine was observed
in blood. Production of this amine was the
result of the following reaction:
A. Decarboxylation
B. Hydroxylation
C. Dehydrogenation
D. Deaminization
E. Reduction
35. A 26-year-old woman consulted a doctor
about having stool with white flat moving
organisms resembling noodles. Laboratory
analysis revealed proglottids with the
following characteristics: long, narrow, wi-
th a longitudinal channel of the uterus with
17-35 lateral branches on each side. What
kind of intestinal parasite was found?
A. Taeniarhynchus saginatus
B. Taenia solium
C. Hymenolepis nana
D. Diphyllobothrium latum
E. Echinococcus granulosus
36. A man is 28 years old. Histological
investigation of the cervical lymph node
revealed a change of its pattern due to proli-
feration of epithelioid, lymphoid cells and
macrophages with horseshoe-shaped nuclei.
In the center of some cell clusters there
were non-structured light-pink areas with
fragments of nuclei. What disease are these
changes typical of?
4
A. Tuberculosis
B. Hodgkin’s disease
C. Actinomycosis
D. Tumor metastasis
E. Syphilis
37. Sex chromatin was detected during
examination of a man’s buccal epitheli-
um. It is characteristic of the following
chromosome disease:
A. Klinefelter’s syndrome
B. Down’s disease
C. Turner’s syndrome
D. Triple X syndrome
E. Hypophosphatemic rickets
38. A patient, having suffered a thermal
burn, developed painful boils filled with
turbid liquid in the skin. What morphologi-
cal type of inflammation has developed in
the patient?
A. Serous
B. Proliferative
C. Croupous
D. Granulomatous
E. Diphtheritic
39. Autopsy of a man with tuberculosis
revealed a 3x2 cm large cavity in the superi-
or lobe of the right lung. The cavity was
interconnected with a bronchus, its wall
was dense and consisted of three layers:
the internal layer was pyogenic, the middle
layer was made of tuberculous granulation
tissue and the external one was made of
connective tissue. What is the most likely
diagnosis?
A. Fibrous cavernous tuberculosis
B. Fibrous focal tuberculosis
C. Tuberculoma
D. Acute focal tuberculosis
E. Acute cavernous tuberculosis
40. A 7-year-old child has acute onset of di-
sease: temperature rise up to 38o C , 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 caused the
changes in the buccal mucosa?
A. Catarrhal inflammation
B. Suppurative inflammation
C. Fibrinous inflammation
D. Hemorrhagic inflammation
E. Serous inflammation
41. After a traffic accident a 36-year-old
patient has developed muscle paralysis of
the extremitis on the right, lost pain and
thermal sensitivity on the left, and partially
lost tactile sensitivity on both sides. What
part of the brain is the most likely to be
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
damaged?
A. Right-hand side of the spinal cord
B. Motor cortex on the left
C. Left-hand side of the spinal cord
D. Anterior horn of the spinal cord
E. Posterior horn of the spinal cord
42. A 4-year-old child has been admitted to
an orthopaedic department with displaced
shin fracture. Bone fragments reposition
requires analgesia. What drug should be
chosen?
A. Promedol
B. Analgin
C. Morphine hydrochloride
D. Panadol
E. -
43. While examining foot blood supply a
doctor checks the pulsation of a large artery
running in the separate fibrous channel in
front of articulatio talocruralis between the
tendons of long extensor muscles of hallux
and toes. What artery is it?
A. A. dorsalis pedis
B. A. tibialis anterior
C. A. tarsea medialis
D. A. tarsea lateralis
E. A. fibularis
44. Representatives of a certain human
population can be characterized by
elongated body, height variability, decreased
volume of muscle mass, increased length
of limbs, decreased size and volume of rib
cage, increased perspiration, decreased indi-
ces of base metabolism and fat synthesis.
What type of adaptive evolution is it?
A. Tropical
B. Arctic
C. Moderate
D. Intermediate
E. Mountain
45. A 59-year-old woman has been hospiali-
zed in a surgical ward due to exacerbation of
chronic osteomyelitis of the left shin. Blood
test: leukocytes - 15, 0 · 109 /l. Leukogram:
myelocytes - 0%, metamyelocytes -
8%, stab neutrophils - 28%, segmented
neutrophils - 32%, lymphocytes - 29%,
monocytes - 3%. Such blood count would
be called:
A. Regenerative left shift
B. Right shift
C. Hyperregenerative left shift
D. Degenerative left shift
E. Regenerative-degenerative left shift
46. A 41-year-old man has a hi-
story of recurrent attacks of heartbeats
5
(paroxysms), profuse sweating, headaches.
Examination revealed hypertension,
hyperglycemia, increased basal metabolic
rate, and tachycardia. These clinical
presentations are typical of the following
adrenal pathology:
A. Hyperfunction of the medulla
B. Hypofunction of the medulla
C. Hyperfunction of the adrenal cortex
D. Hypofunction of the adrenal cortex
E. Primary aldosteronism
47. During autopsy of a man, who di-
ed of acute transmural cardiac infarction,
the following has been detected on the
pericardium surface: fibrous whitish-brown
deposit connecting parietal and visceral
pericardial layers. What kind of inflammati-
on occurred in the pericardium?
A. Croupous
B. Diphtheritic
C. Serous
D. Suppurative
E. Granulomatous
48. A 12-year-old child developed nephri-
tic syndrome (proteinuria, hematuria, cyli-
ndruria) 2 weeks after a case of tonsilli-
tis, which is a sign of affected glomerular
basement membrane in the kidneys. What
mechanism is the most likely to cause the
basement membrane damage?
A. Immune complex
B. Granulomatous
C. Antibody-mediated
D. Reaginic
E. Cytotoxic
49. A man arrived into a traumatologi-
cal department with a trauma of the right
shoulder. Examination revealed a displaced
humeral shaft fracture on the right in the
middle one-third of the humerus; the pati-
ent cannot extend the fingers of his right
hand. What nerve is damaged?
A. Radial
B. Ulnar
C. Median
D. Musculocutaneous
E. Axillary
50. 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:
A. Alveolar macrophages
B. Respiratory epithelial cells
C. Secretory epithelial cells
D. Capillary endothelial cells
E. Pericapillary cells
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 6

51. What drug will be the most appropriate A. Malaria

for a patient suffering from chronic gastritis
with increased secretion?
A. Pirenzepine
B. Pancreatine
C. Pepsin
D. Aprotinin
E. Chlorphentermine
52. A 63-year-old man, who has been
suffering from chronic fibrous-cavernous
pulmonary tuberculosis for 24 years, has
been delivered to a nephrology department
with uremia. Intravital diagnostic test for
amyloid in the kidneys was positive. What
amyloidosis is it in this case?
A. Secondary systemic
B. Primary systemic
C. Localized (focal)
D. Hereditary (genetic)
E. Senile
53. Cells of a healthy liver actively synthesi-
ze glycogen and proteins. What organelles
are the most developed in them?
A. Granular and agranular endoplasmic
reticulum
B. Cell center
C. Lysosomes
D. Mitochondria
E. Peroxisomes
54. Immune-enzyme assay has detected
HBs antigen in blood serum. What disease
is it characteristic of?
A. Viral hepatitis type B
B. Viral hepatitis type A
C. AIDS
D. Tuberculosis
E. Syphilis
55. A patient has been diagnosed with
gonorrhea. As fluoroquinolones are the
drugs of choce for treatment of gonorrhea
the patient should be prescribed:
A. Ciprofloxacin
B. Furazolidone
C. Fluorouracil
D. Sulfacarbamide (Urosulfanum)
E. Cefazolin
56. Autopsy of a Middle-Eastern woman,
who had been suffering from wasting
fever for a long time, revealed enlarged
blackened liver and spleen. Bone marrow
was hyperplastic and black-colored as well.
Cerebral cortex was smoky grey. What di-
sease is it characteristic of?
B. AIDS
C. Epidemic typhus
D. Sepsis
E. Hepatitis
57. Human red blood cells contain no mi-
tochondria. What is the main pathway for
ATP production in these cells?
A. Anaerobic glycolysis
B. Aerobic glycolysis
C. Oxidative phosphorylation
D. Creatine kinase reaction
E. Cyclase reaction
58. Atria of an experimental animal were
superdistended with blood, which resulted
in decreased reabsorption of Na+ and water
in renal tubules. This can be explained by
the influence of the following factor on ki-
dneys:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
59. A woman gave birth to a stillborn
baby with numerous malformations. What
protozoan disease could cause intrauterine
death?
A. Toxoplasmosis
B. Leishmaniasis
C. Malaria
D. Amebiasis
E. Lambliasis
60. A 42-year-old patient complains of
pain in the epigastral area, vomiting; vomit
masses have the color of coffee-grounds;
the patient suffers from melena. Anamnesis
records gastric ulcer disease. Blood formula:
erythrocytes - 2, 8 · 1012 /l, leukocytes -
8 · 109 /l, Hb- 90 g/l. What complication is
it?
A. Hemorrhage
B. Penetration
C. Perforation
D. Canceration
E. Pyloric stenosis
61. A patient has been hospitalised
with provisional diagnosis of virus B
hepatitis. Serological reaction based on
complementation of antigen with antibody
chemically bound to peroxidase or alkaline
phosphatase was used for disease diagnosti-
cs. What is the name of the applied serologi-
cal reaction?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
A. Immune-enzyme analysis
B. Radioimmunoassay
C. Immunofluorescence test
D. Bordet-Gengou test
E. Antigen-binding assay
62. A patient with insulin-dependent di-
abetes mellitus has been administered
insulin. After a certain period of time
the patient developed fatigue, irritabili-
ty, excessive sweating. What is the main
mechanism of such presentations developi-
ng?
A. Carbohydrate starvation of the brain
B. Increased glycogenolysis
C. Increased ketogenesis
D. Increased lipogenesis
E. Decreased glyconeogenesis
63. Examination of a 52-year-old woman
has revealed a decrease in the amount
of red blood cells and an increase in
free hemoglobin in the blood plasma
(hemoglobinemia). Color index is 0,85.
What type of anemia is being observed in
the patient?
A. Acquired hemolytic
B. Hereditary hemolytic
C. Acute hemorrhagic
D. Chronic hemorrhagic
E. Anemia due to diminished erythropoiesis
64. Poisoning caused by mercury (II) chlori-
de (corrosive sublimate) occurred in the
result of safety rules violation. In 2 days
the patient’s diurnal diuresis was 620 ml.
The patient developed headache, vomiting,
convulsions, dyspnea; moist crackles were
observed in the lungs. Name this pathology:
A. Acute renal failure
B. Chronic renal failure
C. Uremic coma
D. Glomerulonephritis
E. Pyelonephritis
65. 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 perspiratory
glands:
A. Aldosterone
B. Vasopressin
C. Cortisol
D. Tgyroxin
E. Natriuretic
66. 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:
7
A. Heat radiation
B. Heat conduction
C. Convection
D. Evaporation
E. -
67. Due to destruction of certain structures
of the brainstem an animal has lost its ori-
entation reflexes in response to strong light
stimuli. What structures were destroyed?
A. Anterior quadrigeminal bodies
B. Posterior quadrigeminal bodies
C. Red nuclei
D. Vestibular nuclei
E. Substantia nigra
68. Urine analysis has shown high levels of
protein and erythrocytes in urine. This can
be caused by the following:
A. Renal filter permeability
B. Effective filter pressure
C. Hydrostatic blood pressure in glomerular
capillaries
D. Hydrostatic primary urine pressure in
capsule
E. Oncotic pressure of blood plasma
69. Along with normal hemoglobin types
there can be pathological ones in the organi-
sm of an adult. Name one of them:
A. HbS
B. HbF
C. HbA1
D. HbA2
E. HbO2
70. Development of both immune and
allergic reactions is based upon the same
mechanisms of immune system response
to an antigen. What is the main difference
between immune and allergic reactions?
A. Development of tissue lesion
B. Amount of released antigen
C. Antigen structure
D. Routes by which antigens are delivered
into the body
E. Hereditary predisposition
71. Histologic preparation stained wi-
th orcein demonstrates from 40 to 60
fenestrated elastic membranes within the
middle coat of vessel. Name this vessel:
A. Elastic artery
B. Muscular artery
C. Mixed type artery
D. Muscular vein
E. Nonmuscular vein
72. Angiocardiography of a 60-year-old man
revealed constriction of a vessel located in
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
the left coronary sulcus of the heart. Name
this pathological vessel:
A. Ramus circumflexus
B. Ramus interventricularis posterior
C. A. coronaria dextra
D. V.cordis parva
E. Ramus interventricularis anterior
73. A comatose patient was taken to the
hospital. He has a history of diabetes melli-
tus. Objectively: Kussmaul breathing, low
blood pressure, acetone odor of breath.
After the emergency treatment the pati-
ent’s condition improved. What drug had
been administered?
A. Insulin
B. Adrenaline
C. Isadrinum
D. Glibenclamide
E. Furosemide
74. A patient complains of pain in the ri-
ght lateral abdomen. Palpation revealed a
dense, immobile, tumor-like formation. The
tumor is likely to be found in the following
part of the digestive tube:
A. Colon ascendens
B. Colon transversum
C. Colon descendens
D. Colon sigmoideum
E. Caecum
75. A patient hospitalized due to mercury
intoxication presents with the followi-
ng processes in the kidneys: focal
necrotic changes of tubules of major
renal regions, edema, leukocyte infiltrati-
on and hemorrhages in the interstitial ti-
ssue, venous congestion. What condition
developed in the patient?
A. Acute necrotic nephrosis
B. Acute glomerulonephritis
C. Chronic renal failure
D. Acute pyelonephritis
E. Chronic pyelonephritis
76. According to phenotypic diagnosis a
female patient has been provisionally di-
agnosed with X-chromosome polysomia.
This diagnosis can be confirmed by
cytogenetic method. What karyotype will
confirm the diagnosis?
A. 47(ХХХ)
B. 48(XXXY)
C. 48(XXYY)
D. 47(XXY)
E. 46(XX)
77. An uconscious young man in the state of
morphine intoxication has been delivered
into an admission room. The patient’s respi-
8
ration is slow and shallow due to suppressi-
on of the respiratory center. What kind of
respiratory failure occurred in this case?
A. Ventilatory disregulation
B. Ventilatory obstruction
C. Ventilatory restriction
D. Perfusion
E. Diffusion
78. On histological examination of uterine
mucosa the following is detected: sinuous
glands, serratiform and corkscrew-shaped
elongated growths of stroma with cell proli-
feration. Make the diagnosis:
A. Glandular endometrial hyperplasia
B. Acute endometritis
C. Leiomyoma
D. Vesicular mole
E. Placental polyp
79. 10 minutes after the beginning of
heavy physical work a person demonstrates
increase of erythrocyte number in blood
from 4, 0 · 1012 /l to 4, 5 · 1012 /l. What is the
cause of this phenomenon?
A. Erythrocytes exit from depot
B. Suppression of erythrocyte destruction
C. Erythropoiesis activation
D. Increase of cardiac output
E. Water loss
80. A patient has a traumatic injury
of sternocleidomastoid muscle. This has
resulted in a decrease of the following value:
A. Inspiratory reserve volume
B. Expiratory reserve volume
C. Respiratory volume
D. Residual volume
E. Functional residual lung capacity
81. Autopsy of a 40-year-old woman,
who died of cerebral hemorrhage duri-
ng hypertensic crisis, revealed: upper-
body obesity, hypertrichosis, hirsutism,
stretchmarks on the skin of thighs and
abdomen. Pituitary basophil adenoma is
detected in the anterior lobe. What di-
agnosis is the most likely?
A. Cushing’s disease
B. Essential hypertension
C. Alimentary obesity
D. Simmonds’ disease
E. Hypothalamic obesity
82. A specimen shows an organ covered
with the connective tissue capsule with
radiating trabeculae. There is also cortex
containing lymph nodules, and medullary
cords made of lymphoid cells. What organ
is under study?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
A. Lymph node
B. Thymus
C. Spleen
D. Red bone marrow
E. Tonsils
83. After a craniocerebral injury a patient
has lost the ability to recognize shapes of
objects by touch (stereognosis). What area
of cerebral cortex normally contains the
relevant center?
A. Superior parietal lobule
B. Inferior parietal lobule
C. Supramarginal gyrus
D. Postcentral gyrus
E. Angular gyrus
84. Monoamine oxidase inhibitors are
widely used as psychopharmacological
drugs. They change the level of nearly
all neurotransmitters in synapses, with
the following neurotransmitter being the
exception:
A. Acetylcholine
B. Noradrenaline
C. Adrenaline
D. Dopamine
E. Serotonin
85. A worker of an agricultural enterprise
had been suffering from an acute disease
with aggravating intoxication signs, which
resulted in his death. On autopsy: the spleen
is enlarged, flaccid, dark cherry-red in the
section, yields excessive pulp scrape. Soft
meninges of fornix and base of the brain
are edematous and saturated with blood
(”cardinal’s cap”). Microscopically: serous-
hemorrhagic inflammation of meninges and
cerebral tissues. Make the diagnosis:
A. Anthrax
B. Tularemia
C. Plague
D. Cholera
E. Brucellosis
86. Autopsy of an 8-month-old boy, who di-
ed of severe pneumonia complicated with
sepsis, revealed absence of thymus. Lymph
nodes have no lymphoid follicles and corti-
cal substance. In the spleen the follicles are
decreased in size and have no light centers.
What is the cause of such changes?
A. Thymus agenesis
B. Thymus aplasia
C. Thymus atrophy
D. Thymus hypoplasia
E. Accidental thymic involution
87. A patient has been delivered into a
surgical ward with an incised wound of the
anterior surface of the shoulder in its lower
9
one-third. Flexing function was disrupted
in the shoulder and elbow joints, which is
caused by the damage to the:
A. Biceps muscle of the arm
B. Triceps muscle of the arm
C. Anconeus muscle
D. Deltoid muscle
E. Coracobrachial muscle
88. A 40-year-old patient suffers
from bronchial asthma and prolonged
tachycardia. Choose the optimal drug for
rapid relief of bronchial spasm in the given
case:
A. Salbutamol
B. Adrenalin hydrochloride
C. Ephedrine hydrochloride
D. Orciprenaline
E. Isoprenaline (Isadrinum)
89. A patient with urolithiasis has
developed severe pain attacks. For pain
shock prevention he was administered an
antispasmodic narcotic analgesic along with
atropine. Name this drug:
A. Promedol
B. Nalorphine
C. Tramadol
D. Ethylmorphine hydrochloride
E. Morphine hydrochloride
90. A patient suffers from acute cardi-
opulmonary failure with pulmonary edema.
What diuretic should be prescribed in the
given case?
A. Furosemide
B. Triamterene
C. Spironolactone
D. Hydrochlorothiazide (Dichlothiazidum)
E. Acetazolamide (Diacarb)
91. A patient with acute myocardial infarcti-
on has been administered heparin as a
part of complex therapy. Some time after
heparin injection the patient developed
hematuria. What heparin antagonist should
be injected to remove the complication?
A. Protamine sulfate
B. Vicasol
C. Aminocaproic acid
D. Neodicumarin
E. Fibrinogen
92. The key reaction of fatty acid synthesis
is production of malonyl-CoA. What
metabolite is the source of malonyl-CoA
synthesis?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 10

A. Acetyl-CoA A. Balantidiasis
B. Succinyl-CoA B. Amebiasis
C. Acyl-CoA C. Toxoplasmosis
D. Malonate D. Lambliasis
E. Citrate E. Trichomoniasis
93. A family of healthy students, who have 98. Blood group of a 30-year-old man has
arrived from Africa, gave birth to a chi- been determined before a surgery. The
ld with signs of anemia. The child has di- blood was Rhesus-positive. Agglutination
ed shortly after. Examination has revealed did not occur with standard 0 (I), А (II),
that the child’s erythrocytes are abnormally and В (III) serums. The blood belongs to
crescent-shaped. The disease is characreri- the following group:
zed by autosomal recessive inheritance.
Determine the genotype of the child’s A. 0 (I)
parents: B. А (II)
C. В (III)
A. Аа х Аа
B. Аа х аа D. АВ (IV)
C. АА х АА E. -
D. аа х аа 99. Histological specimen of a hemopoietic
E. Аа х АА organ shows clusters of node- and band-
94. At a certain stage of cell cycle shaped lymphocytes that along with stroma
chromosomes reach cellular poles, undergo elements compose cortical and medullar
despiralization; nuclear membranes are substances. Name this organ:
being formed around them; nucleolus is A. Lymph node
restored. What stage of mitosis is it? B. Spleen
A. Telophase C. Red bone marrow
B. Prophase D. Thymus
C. Prometaphase E. Palatine tonsil
D. Metaphase 100. It is known that in catecholami-
E. Anaphase ne metabolism a special role belongs
95. Cardiac arrest occurred in a patient to monoamine oxidase (MAO). This
during a surgery of the small intestine. enzyme inactivates mediators (noadrenalin,
What regulatory mechamisms resulted in adrenalin, dopamine) by:
the cardiac arrest in this case?
A. Oxidative deamination
A. Unconditioned parasympathetic reflexes B. Adjoining amino groups
B. Unconditioned sympathetic reflexes C. Removing methyl groups
C. Conditioned parasympathetic reflexes D. Carboxylation
D. Conditioned sympathetic reflexes E. Hydrolysis
E. Metasympathetic reflexes
101. Cellular composition of exudate
96. Vestibular receptors of semicircular largely depends on the etiological factor of
canals of an animal have been destroyed. inflammation. What leukocytes are the first
What reflexes will disappear as a result? to be involved in the focus of inflammation
caused by pyogenic bacteria?
A. Statokinetic reflex during movements
with angular acceleration A. Neutrophil granulocytes
B. Statokinetic reflex during movements B. Monocytes
with linear acceleration C. Myelocytes
C. Head-righting reflex D. Eosinophilic granulocytes
D. Body-righting reflex E. Basophils
E. Primary orienting reflex
102. A surgeon has detected inflammation
97. A patient working at a pig farm complai- of the Meckel’s diverticulum in a patient.
ns of paroxysmal abdominal pain, liquid During surgical invasion it can be located in
feces with mucus and blood, headache, the:
weakness, fever. Examination of large
intestine revealed ulcers from 1 mm up to A. Ileum
several cm in diameter, feces contained oval B. Jejunum
unicellular organisms with cilia. What di- C. Colon
sease can be suspected? D. Duodenum
E. Sigmoid colon
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
103. A patient complains of acute pain
attacks in the right lumbar region. Duri-
ng examination the nephrolithic obturation
of the right ureter in the region between
its abdominal and pelvic segments was
detected. What anatomical boundary exi-
sts between those two segments?
A. Linea terminalis
B. Linea semilunaris
C. Linea arcuata
D. Linea transversa
E. Linea inguinalis
104. A patient died of cancerous cachexia
with primary localization of cancer in the
stomach. Autopsy revealed acutely enlarged
liver with uneven surface and numerous
protruding nodes; the nodes had clear
margins in the section, rounded shape,
gray-pink color, varying density, someti-
mes contained necrotic foci. Histologically:
there are atypical cells in the nodes. What
pathologic process occurred in the liver?
A. Cancer metastases
B. Abscesses
C. Regeneratory nodes
D. Infarction
E. Hepatic cancer
105. A patient has insufficient blood
supply to the kidneys, which 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:
A. Angiotensin II
B. Angiotensinogen
C. Renin
D. Catecholamines
E. Norepinephrine
106. Experimental stimulation of
sympathetic nerve branches that innervate
heart caused an increase in force of heart
contractions because membrane of typical
cardiomyocytes permitted an increase in:
A. Calcium ion entry
B. Calcium ion exit
C. Potassium ion exit
D. Potassium ion entry
E. Calcium and potassium ion exit
107. Parents of a 5-year-old child report him
to have frequent colds that develop into
pneumonias, presence of purulent rashes
on the skin. Laboratory tests have revealed
the following: absence of immunoglobuli-
ns of any type; naked cells are absent from
the lymph nodes punctate. What kind of
immune disorder is it?
11
A. X-linked hypogammaglobulinemia
(Bruton type agammaglobulinemia)
B. Autosomal recessive agammaglobuli-
naemia (Swiss type)
C. Hypoplastic anemia
D. Agranulocytosis
E. Louis-Barr syndrome
108. A microslide contains the specimen
of a gland composed of several secretory
saccule-shaped parts that open in the
common excretory duct. What gland is it?
A. Simple branched alveolar gland
B. Compound branched alveolar gland
C. Simple unbranched alveolar gland
D. Compound unbranched alveolar gland
E. Simple branched tubular gland
109. Microelectrode technique allowed to
register a potential following ”all-or-none”
law and capable of undecremental spreadi-
ng. Specify this potential:
A. Action potential
B. Excitatory postsynaptic potential
C. Rest potential
D. Inhibitory postsynaptic potential
E. Receptor potential
110. Examination of a patient revealed
hypertrophy and inflammation of lymphoid
tissue, edema of mucous membrane
between palatine arches (acute tonsillitis).
What tonsil is normally situated in this area?
A. Tonsilla palatina
B. Tonsilla pharyngealis
C. Tonsilla tubaria
D. Tonsilla lingualis
E. -
111. Histological specimen of an ovary
demonstrates a spherical structure
composed of large glandular cells contai-
ning lutein. What hormone is produced by
the cells of this structure?
A. Progesterone
B. Estrogens
C. Testosterone
D. Corticosterone
E. Aldosterone
112. A patient, who has been subsisting
exclusively on polished rice, has developed
polyneuritis due to thiamine deficiency.
What substance is an indicator of such avi-
taminosis, when it is excreted with urine?
A. Pyruvic acid
B. Malate
C. Methylmalonic acid
D. Uric acid
E. Phenyl pyruvate
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
113. When blood circulation in the damaged
tissue is restored, lactate accumulation
stops and glucose consumption decelerates.
These metabolic changes are caused by acti-
vation of the following process:
A. Aerobic glycolysis
B. Anaerobic glycolysis
C. Lipolysis
D. Gluconeogenesis
E. Glycogen biosynthesis
114. A 67-year-old patient complains of
periodic heartache, dyspnea during light
physical activities. ECG reveals extraordi-
nary contractions of heart ventricles. Such
arrhythmia is called:
A. Extrasystole
B. Bradycardia
C. Tachycardia
D. Flutter
E. Fibrillation
115. In investigation of serum proteins vari-
ous physical and physicochemical methods
can be used. In particular, serum albumi-
ns and globulins can be separated by the
method of:
A. Electrophoresis
B. Polarography
C. Dialysis
D. Spectrography
E. Refractometry
116. Pupil dilation occurs when a person
steps from a light room into a dark one.
What reflex causes such a reaction?
A. Sympathetic unconditioned reflex
B. Sympathetic conditioned reflex
C. Metasympathetic reflex
D. Parasympathetic unconditioned reflex
E. Parasympathetic conditioned reflex
117. Cells of a person working in the
Chornobyl Exclusion Zone have undergone
a mutation in DNA molecule. However,
with time the damaged interval of DNA
molecule has been restored to its initial
structure with a specific enzyme. In this case
the following occurred:
A. Repair
B. Replication
C. Transcription
D. Reverse transcription
E. Translation
118. Autopsy of a 5-year-old child revealed
in the area of the vermis of cerebellum a soft
grayish-pink node 2 cm in diameter with
blurred margins and areas of haemorrhage.
Histologically this tumour consisted of
atypical monomorphous small round cells
12
with large polymorphous nuclei. What
tumour is it?
A. Medulloblastoma
B. Meningioma
C. Glioblastoma
D. Astrocytoma
E. Oligodendroglioma
119. When studying the signs of pulmonary
ventilation, reduction of forced expiratory
volume has been detected. What is the li-
kely cause of this phenomenon?
A. Obstructive pulmonary disease
B. Increase of respiratory volume
C. Increase of inspiratory reserve volume
D. Increase of pulmonary residual volume
E. Increase of functional residual lung
capacity
120. A specimen of a parenchymal organ
shows poorly delineated hexagonal lobules
surrounding a central vein, and the
interlobular connective tissue contains
embedded triads (an artery, a vein and an
excretory duct). What organ is it?
A. Liver
B. Pancreas
C. Thymus
D. Spleen
E. Thyroid
121. A patient had a trauma that caused
dysfunction of motor centers regulating
activity of head muscles. In what parts of
cerebral cortex can these centers normally
be located?
A. Inferior part of precentral gyrus
B. Superior part of precentral gyrus
C. Supramarginal gyrus
D. Superior parietal lobule
E. Angular gyrus
122. At the post-mortem examination the
stomach of a patient with renal failure was
found to have a yellow-brown coating on
the thickened mucosa. The coating was fi-
rmly adhering to its surface and had si-
gnificant thickness. Microscopy revealed
congestion and necrosis of mucosal and
submucosal layers, fibrin presence. What is
the most likely diagnosis?
A. Fibrinous gastritis
B. Croupous gastritis
C. Gastric abscess
D. Esogastritis
E. Corrosive gastritis
123. A 60-year-old man suffering from
chronic hepatitis frequently observes nasal
and gingival hemorrhages, spontaneous
hemorrhagic rashes on the skin and mucosa.
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
Such presentations result from:
A. Decreased synthesis of prothrombin and
fibrinogen
B. Increased blood content of ami-
notransferases
C. Decreased synthesis of serum albumins
D. Increased blood content of macroglobuli-
ns and cryoglobulins
E. Decreased blood content of choli-
nesterase
124. Leading symptoms of primary
hyperparathyroidism are osteoporosis and
renal damage resulting in urolithiasis
development. What substances are the basis
of uroliths in such cases?
A. Calcium phosphate
B. Uric acid
C. Cystine
D. Bilirubin
E. Cholesterol
125. An oncology department has admitted
a patient with suspected pulmonary tumor.
On examination a pathology localized wi-
thin the lower lobe of the right lung was
detected. How many bronchopulmonary
segments are there in this lobe?
A. 5
B. 6
C. 4
D. 3
E. 2
126. A 45-year-old woman suffers
from arterial hypertension with high
blood concentration of angiotensin II.
What antihypertensive drug is the most
recommended in the given case?
A. Lisinopril
B. Prazosin
C. Metoprolol
D. Reserpine
E. Verapamil
127. An alcoholic suffers from alcoholic
psychosis with evident psychomotor agitati-
on. What neuroleptic drug should be admi-
nistered for emergency aid?
A. Aminazine
B. Diazepam
C. Sodium bromide
D. Reserpine
E. Halothane
128. In one of Polessia regions there was
an outbreak of helminthiasis manifested by
cramps and facial edemas. The developed
preventive measures in particular included
ban for eating infested pork even after
heat processing. What helminthiasis was the
13
case?
A. Trichinosis
B. Taeniarhynchosis
C. Teniasis
D. Echinococcosis
E. Alveococcosis
129. A patient demonstrates functional loss
of nasal halves of the retinas. What area of
visual pathways is affected?
A. Optic chiasm
B. Left optic tract
C. Right optic tract
D. Left optic nerve
E. Right optic nerve
130. A 26-year-old woman with bronchitis
has been administered a broad spectrum
antibiotic as a causal treatment drug. Speci-
fy this drug:
A. Doxycycline
B. Interferon
C. BCG vaccine
D. Ambroxol
E. Dexamethasone
131. A 16-year-old young man sufferi-
ng from seasonal allergic rhinitis has
been prescribed a highly active second-
generation H1 blocker, which can be
characterized by absence of marked sedati-
ve action. Name this drug:
A. Loratadine
B. Pipolphen
C. Chloropyramine (Suprastin)
D. Indometacin
E. Erythromycin
132. Examination of a 56-year-old woman
with a history of type 1 diabetes mellitus
revealed a disorder of protein metaboli-
sm that is manifested by aminoacidemia in
the laboratory blood test values, and cli-
nically by the delayed wound healing and
decreased synthesis of antibodies. Which
of the following mechanisms causes the
development of aminoacidemia?
A. Increased proteolysis
B. Albuminosis
C. Decrease in the concentration of amino
acids in blood
D. Increase in the oncotic pressure in the
blood plasma
E. Increase in low-density lipoprotein level
133. A patient with injury sustained to a part
of the central nervous system demonstrates
disrupted coordination and movement
amplitude, muscle tremor during volitional
movements, poor muscle tone. What part of
the central nervous system was injured?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
A. Cerebellum
B. Medulla oblongata
C. Oliencephalon
D. Mesencephalon
E. Prosencephalon
134. A 36-year-old patient has been admini-
stered a depolarizing muscle relaxant duri-
ng a surgery. Name this drug:
A. Dithylinum
B. Proserin
C. Pipecuronium bromide (Arduan)
D. Diazepam
E. Aminazine
135. A man has suffered multiple bone
fractures of his lower extremities duri-
ng a traffic accident. During transportati-
on to a hospital his condition was further
aggravated: blood pressure decreased, there
were signs of pulmonary artery embolism.
What kind of embolism is the most likely in
the given case?
A. Fat embolism
B. Air embolism
C. Gas embolism
D. Tissue embolism
E. Thromboembolism
136. UN volunteers have arrived in Ni-
geria to assist the locals in aftermath
of earthquakes. What drug should they
prescribe for individual chemoprophylaxis
of malaria?
A. Chingamin
B. Pyrantel
C. Pyrimethamine (Chloridinum)
D. Primaquine
E. Interferon (Laferon)
137. After an extended treatment wi-
th sulfanamides a patient has developed
macrocytic anemia. Production of active
forms of the following vitamin is disrupted
in such a condition:
A. Folic acid
B. Thiamine
C. Riboflavin
D. Pyridoxine
E. Cyanocobalamin
138. A woman resting in the countrysi-
de has been stung by a bee. Immediately
after she developed pain in the stung area.
In a few minutes there developed a vesi-
cle, erythema and intense itch; later - urti-
caria and expiratory dyspnea. What factors
resulted in the patient developing expi-
ratory dyspnea?
14
A. Histamine
B. Hageman’s factor
C. Lysosomal enzymes
D. Noradrenaline
E. Adrenaline
139. Autopsy of a 28-year-old patient, who
had been suffering from rheumatism and
died of heart failure, revealed pancardi-
tis. Histological investigation of myocardi-
um of the left ventricle posterior wall
and interventricular septum detected peri-
vascular cellular focal infiltrates composed
of macrophages and creating palisade
structures surrounding areas of fibrinoid
necrosis. Determine the type of myocarditis:
A. Granulomatous
B. Diffuse interstitial productive
C. Diffuse interstitial exudative
D. Focal interstitial exudative
E. -
140. When ascending to the top of Elbrus,
a mountain climber experiences oxygen
starvation, dyspnea, palpitations, and
numbness of the extremities. What kind of
hypoxia has developed in the mountain cli-
mber?
A. Hypoxic
B. Circulatory
C. Hemic
D. Tissue
E. Cardiac
141. A 2-year-old boy is diagnosed wi-
th Down syndrome. What chromosomal
changes can cause this disease?
A. Trisomy 21
B. Trisomy 13
C. Trisomy X
D. Trisomy 18
E. Monosomy X
142. A 62-year-old patient has been hospi-
talized due to massive cerebral hemorrhage.
Blood pressure is 70/30 mm Hg, heart
rate is 120/min., respiratory rate is 4/min.,
unconscious, no response to external sti-
muli. Such condition can be determined as:
A. Coma
B. Shock
C. Collapse
D. Stress
E. Agony
143. A 3-year-old girl with mental retardati-
on has been diagnosed with sphingomyelin
lipidosis (Niemann-Pick disease). In this
condition synthesis of the following
substance is disrupted:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
A. Sphingomyelinase
B. Glycosyltransferase
C. Sphingosine
D. Ceramides
E. Gangliosides
144. What condition may develop 15-30 mi-
nutes after re-administration of an antigen
as a result of the increased level of anti-
bodies, mainly IgE, that are adsorbed on
the surface of target cells, namely tissue
basophils (mast cells) and blood basophi-
ls?
A. Anaphylaxis
B. Antibody-dependent cytotoxicity
C. Delayed-type hypersensitivity
D. Immune complex hyperresponsiveness
E. Serum sickness
145. Local anesthetics (novocaine, lidocaine
and others) decreases pain sensitivity of ti-
ssues by blocking Na+ and K + ions from
permeating membranes of nerve fibers and
endings. Such mechanism of drug action is
called:
A. Membrane ionic
B. Receptor
C. Enzyme
D. Antienzyme
E. Direct chemical
146. After a road accident a victim has
tachycardia, arterial blood pressure 130/90
mm Hg, tachypnoe, the skin is pale and
dry, excitation of central nervous system is
observed. What shock stage is the patient
most likely in?
A. Erectile
B. Terminal
C. Torpid
D. Preshock (compensation stage)
E. Agony
147. A woman complaining of sharp pain
in her lower abdomen has been delivered
into an admission room. A gynecologist on
examination makes a provisional diagnosis
of extrauterine pregnancy. What anatomical
structure should be punctated to confirm di-
agnosis?
A. Rectouterine pouch
B. Utriculosaccular chamber
C. Recto-vesical pouch
D. Retropubic space
E. Intersigmoidal recess
148. A passenger of a fixed-run taxi has a
sudden and expressed attack of tachycardia.
A doctor travelling by the same taxi has
managed to slow down his heart rate by
pressing upon the eyeballs and thus causing
15
the following reflex:
A. Dagnini-Aschner reflex
B. Bainbridge reflex
C. Holtz’s reflex
D. Hering-Breuer reflex
E. Frank-Starling mechanism
149. A 47-year-old man developed intesti-
nal colic against the background of essenti-
al hypertension. In this situation it would
be the most efficient to arrest the colic by
administering drugs of the following group:
A. Myotropic antispasmodics
B. Anticholinesterase agents
C. Sympathomimetics
D. M-cholinomimetics
E. Adrenomimetics
150. A therapeutist has an appointment
with a 40-year-old patient complaining of
recurrent pain attacks in his hallux joints
and their swelling. Urine analysis revealed
its marked acidity and pink color. What
substances can cause such changes in uri-
ne?
A. Uric acid salt
B. Chlorides
C. Ammonium salts
D. Calcium phosphate
E. Magnesium sulfate
151. Exophthalmus observed during
thyrotoxicosis is caused by accumulation of
highly water-binding substances within the
retrobulbar tissues. Name these substances:
A. Glycosaminoglycans
B. Cholesterol
C. ATP
D. Kreatine
E. Phospholipids
152. A patient presents with dry peeli-
ng skin, frequent cases of acute respi-
ratory diseases, xerophthalmia. What vi-
tamin preparation should be prescribed in
this case?
A. Retinol acetate
B. Thiamine
C. Cyanocobalamin
D. Menadione (Vikasolum)
E. Ergocalciferol
153. Parenchyma of an organ is composed of
pseudounipolar neurons localized under the
capsule of connective tissue. Central place
belongs to nerve fibers. Name this organ:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 16

A. Spinal ganglion A. Testosterone

B. Sympathetic ganglion B. Oestriol
C. Intramural ganglion C. Relaxin
D. Nerve trunk D. Oxytocin
E. Spinal cord E. Prolactin
154. A patient consulted a physician about 159. During a surgery for femoral hernia a
chest pain, cough, fever. Roentgenography surgeon operates within the boundaries of
of lungs revealed eosinophilic infiltrates femoral trigone. What structure makes up
that were found to contain larvae. What ki- its upper margin?
nd of helminthiasis are these presentations
typical of? A. Lig. inguinale
B. Arcus iliopectineus
A. Ascariasis C. Lig. lacunare
B. Echinococcosis D. Lig. pectinale
C. Fascioliasis E. Fascia lata
D. Cysticercosis
E. Trichinosis 160. Activation of a number of hemostatic
factors occurs through their joining with
155. During appendectomy a patient had calcium ions. What structural component
the a. appendicularis ligated. This vessel allows for adjoining of calcium ions?
branches from the following artery:
A. Gamma-carboxyglutamic acid
A. A. ileocolica B. Gamma-aminobutyric acid
B. A. colica dextra C. Gamma-oxybutyric acid
C. A. colica media D. Hydroxyproline
D. A. sigmoidea E. Monoamine-dicarboxylic acids
E. A. mesenterica inferior
161. A patient has arterial hypertension.
156. A patient with signs of osteoporosis What long-acting calcium channel blocker
and urolithiasis has been admitted should be prescribed?
to an endocrinology department.
Blood test revealed hypercalcemia and A. Amlodipine
hypophosphatemia. These changes are B. Octadine
associated with abnormal synthesis of the C. Pyrroxanum
following hormone: D. Atenolol
E. Reserpine
A. Parathyroid hormone
B. Calcitonin 162. Material obtained from a patient
C. Cortisol contains several types of microorganisms
D. Aldosterone (staphylococci and streptococci) causative
E. Calcitriol of the patient’s disease. Name this type of
infection:
157. Prescription of penicillin G sodium
salt has caused development of neurotoxic A. Mixed infection
effects (hallucinations, convulsions). Such B. Superinfection
reaction is the result of antagonism with the C. Reinfection
following neurotransmitter: D. Consecutive infection
E. Coinfection
A. GABA
B. Dopamine 163. A laboratory has been investigati-
C. Serotonin ng virulence of a diphtheria agent. In the
D. Adenosine process of the experiment the infection was
E. Acetylcholine introduced intraperitoneally into test ani-
mals. The dosage of bacteria resulting in
158. A 30-year-old woman exhibits signs 95% mortality of test animals was found.
of virilism (growth of body hair, balding What unit of virulence measurement was
temples, menstrual disorders). This condi- determined?
tion can be caused by overproduction of the
following hormone: A. DLM
B. DCL
C. LD50
D. ID
E. LD5
164. A patient complains of palpitations
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 17

after stress. Pulse is 104/min., P-Q=0,12 A. Ulnar

seconds, there are no changes in QRS B. Median
complex. What type of arrhythmia does the C. Radial
patient have? D. Musculocutaneous
E. Medial cutaneous nerve of the forearm
A. Sinus tachycardia
B. Sinus bradycardia 170. A 30-year-old patient’s blood test has
C. Sinus arrhythmia revealed the following: erythrocyte count
D. Ciliary arrhythmia is 6 · 1012 /l, hemoglobin is 10,55 mmol/l.
E. Extrasystole Vaquez’s disease was diagnosed. Name the
leading part of pathogenesis:
165. A patient consulted a dentist about
restricted mouth opening (trismus). He has A. Neoplastic erythroid hyperplasia
a history of a stab wound of the lower B. Iron-deficiency
extremity. What infection can cause these C. B12 -deficiency
symptoms? D. Hypoxia
E. Acidosis
A. Tetanus
B. Brucellosis 171. Pancreas is known as a mixed gland.
C. Whooping cough Endocrine functions include production
D. Wound anaerobic infection of insulin by beta cells. This hormone
E. Tularemia affects metabolism of carbohydrates. What
is its effect on the activity of glycogen
166. Patient’s systolic blood pressure is phosphorylase (GP) and glycogen synthase
90 mm Hg, diastolic - 70 mm Hg. Such (GS)?
blood pressure is caused by decrease of the
following factor: A. It inhibits GP and activates GS
B. It activates both GP and GS
A. Pumping ability of the left heart C. It inhibits both GP and GS
B. Pumping ability of the right heart D. It activates GP and inhibits GS
C. Aortic compliance E. It does not affect the activity of GP and
D. Total peripheral resistance GS
E. Vascular tone
172. This year influenza epidemic is
167. A 29-year-old man with a knife wound characterised by patients’ body temperature
of the neck presents with bleeding. Duri- varying from 36, 9oC to 37, 9oC . Such fever
ng the initial d-bridement of the wound is called:
a surgeon revealed the injury of a vessel
situated along the lateral edge of the A. Subfebrile
sternocleidomastoid muscle. Specify this B. High
vessel: C. Hyperpyretic
D. Apyretic
A. V. jugularis externa E. Moderate
B. V. jugularis anterior
C. A. carotis externa 173. Fructosuria is known to be connected
D. A. carotis interna with inherited deficiency of fructose 1-
E. V. jugularis interna phosphate aldolase. What product of
fructose metabolism will accumulate in the
168. A 6-year-old child suffers from delayed organism resulting in toxic action?
growth, disrupted ossification processes,
decalcification of the teeth. What can be A. Fructose 1-phosphate
the cause? B. Glucose 1-phosphate
C. Glucose 6-phosphate
A. Vitamin D deficiency D. Fructose 1,6-biphosphate
B. Decreased glucagon production E. Fructose 6-phosphate
C. Insulin deficiency
D. Hyperthyroidism 174. A woman complains of visual impai-
E. Vitamin C deficiency rment. Examination revealed obesity in the
patient and her fasting plasma glucose level
169. A patient addressed a hospital with is hyperglycemic. What diabetes complicati-
complaints of lost sensitivity of the skin of on can cause visual impairment/blindness?
the little finger. What nerve is the most li-
kely to be damaged?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 18

A. Microangiopathy A. Cholera
B. Macroangiopathy B. Shigellosis
C. Atherosclerosis C. Typhoid fever
D. Neuropathy D. Colienteritis
E. Glomerulopathy E. Pseudotuberculosis
175. Administration of doxycycline 180. An athlete (long-distance runner) duri-
hydrochloride has caused an imbalance of ng a contest developed a case of acute cardi-
the symbiotic intestinal microflora. Specify ac insufficiency. This pathology resulted
the kind of imbalance caused by the antibi- from:
otic therapy:
A. Cardiac volume overload
A. Dysbacteriosis B. Disrupted coronary circulation
B. Sensibilization C. Direct damage to myocardium
C. Idiosyncrasy D. Pericardium pathology
D. Superimposed infection E. Cardiac pressure overload
E. Bacteriosis
181. Parkinson’s disease is caused by di-
176. Cholesterol content in blood serum sruption of dopamine synthesis. What brain
of a 12-year-old boy is 25 mmol/l. structure synthesizes this neurotransmitter?
Anamnesis states hereditary familial
hypercholesterolemia caused by synthesis A. Substantia nigra
disruption of receptor-related proteins for: B. Globus pallidus
C. Corpora quadrigemina
A. Low-density lipoproteins D. Red nucleus
B. High-density lipoproteins E. Hypothalamus
C. Chylomicrons
D. Very low-density lipoproteins 182. Name the halogen-containing anti-
E. Middle-density lipoproteins septic with fungicidal properties, which is
used to treat dermatomycosis:
177. During recording of a spirogram a pati-
ent calmly exhaled. How do we call the A. Iodine solution
volume of air remaining in the lungs? B. Formalin solution
C. Methylene blue
A. Functional residual capacity D. Brilliant green
B. Pulmonary residual volume E. Boric acid solution
C. Expiratory reserve volume
D. Tidal volume 183. Due to severe pain syndrome a patient
E. Vital capacity of lungs was prescribed a narcotic analgesic. Name
this drug:
178. A 40-year-old woman was diagnosed
with glomerulonephritis based on her cli- A. Morphine
nical symptoms and the results of urine B. Metamizole (Analgin)
analysis. Anamnesis states chronic tonsilli- C. Nimesulide
tis. What microorganisms are the most likely D. Dimethyl sulfoxide
cause for the kidney damage in this case? E. Indometacin
A. Streptococci 184. During pathomorphological renal
B. Staphylococci investigation of a patient, who for a long
C. Escherichia time had been suffering from osteomyeli-
D. Mycoplasma tis and died of progressing renal fai-
E. Meningococci lure, the following was revealed: deposi-
ts of homogeneous eosinophilic masses
179. A man is suffering from diarrhea. In in glomerular mesangium, arterial and
summer he spent his vacation in the south arteriolar walls, and stroma, which colored
at the sea coast. Bacteria with the following red when stained with Congo red. What
properties were detected in his feces: gram- pathological process is this?
negative curved mobile monotrichous baci-
lli that do not produce spores or capsules. A. Amyloidosis
Bacilli are undemanding to nutrient medi- B. Mucoid swelling
um but require alkaline reaction (рН 8,5- C. Calcinosis
9,5). Described are the agents of the followi- D. Carbohydrate degeneration
ng enteric infection: E. Hyalinosis
185. During experiment a dog has
developed conditioned digestive reflex in
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк
response to a sound stimulus. This conditi-
oned reflex will not be exhibited anymore
after the extirpation of the following areas
of the cerebral hemispheres:
A. Temporal lobe on both sides
B. Occipital lobe on one side
C. Parietal lobe on both sides
D. Temporal lobe on one side
E. Occipital lobe on both sides
186. Coenzym A participates in numerous
important metabolic reactions. It is a deri-
vative of the following vitamin:
A. Pantothenic acid
B. Thiamine
C. Niacin
D. Calciferol
E. Ubiquinone
187. A patient diagnosed with acute
dysentery has been treated for 3 days in an
infectious diseases hospital. On admission
there were complaints of high temperature,
stomachache and fluid excrements with
mucus up to 8-10 times a day. What sample
should be taken for analysis?
A. Feces
B. Urine
C. Bile
D. Liquor
E. Blood
188. A patient with arthritis has been
prescribed an anti-inflammatory selective
COX-2 inhibitor. Select this drug among
those given below:
A. Celecoxib
B. Phenylbutazone (Butadion)
C. Dimethylsulfoxide (Dimexid)
D. Indometacin
E. Metamizole (Analgin)
189. A person with the fourth blood group
(genotype IAIB) has in erythrocytes both
antigen A controlled by allele IA and
antigen B controlled by allele IB. This
phenomenon is an example of the following
gene interation:
A. Codominance
B. Complementarity
C. Semidominance
D. Polymery
E. Epistasis
190. A patient with diabetes mellitus
suffers from persistently nonhealing surgi-
cal wound, which is a sign of disrupted ti-
ssue trophism. What is the cause of such
disorder?
19
A. Disruption of protein metabolism
regulation
B. Hypoglycemia
C. Ketonemia
D. Increased lipid catabolism
E. Anemia
191. A patient with signs of intestinal
infection (vomiting, diarrhea, abdominal
pain) has been presenting with increasing
symptoms of intoxication for three days.
Papular rash appeared on the uncovered
skin areas and spread to the torso. A
doctor suspected pseudotuberculosis. What
laboratory test allows confirming this di-
agnosis within the first week from the onset
of disease?
A. Bacteriological
B. Microscopic
C. Serological
D. Allergic
E. Biological
192. A microslide demonstrates an organ
with its wall consisting of three membranes.
The inner membrane has tubular glands and
undergoes cyclic changes. Name this organ:
A. Uterus
B. Esophagus
C. Vagina
D. Ureter
E. Urinary bladder
193. A patient with femoral neck fracture,
who for a long time had to remain in bed
in a forced (supine) position, has developed
dark-brown lesions along the backbone; soft
tissues are swollen, in the areas of macerati-
on there is a foul-smelling liquid. Name the
clinicopathologic type of necrosis:
A. Bedsore
B. Infarction
C. Sequestrum
D. Coagulation necrosis
E. Dry gangrene
194. A patient is 20 years old, an athlete. He
addressed a doctor with complaints of fati-
gue, fever up to 38o C - 40o C . Objectively:
the liver and spleen are enlarged, lymph
nodes on palpation are slightly enlarged,
dense, painless. Blood test: Нb- 100 g/l;
erythrocytes - 2, 9 · 1012 /l; leukocytes -
4, 4 · 109 /l. Leukogram: 68% of blast cells.
Cytochemical investigation of blast cells
revealed negative reactions to glycogen,
peroxidase, non-specific esterase, lipids.
Name this disease:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2016 рiк 20

A. Acute undifferentiated leukemia edema has developed in the child?

B. Acute myeloid leukemia
C. Acute monoblastic leukemia A. Allergic
D. Acute lymphoblastic leukemia B. Inflammatory
E. Acute megakaryoblastic leukemia C. Cardiac
D. Alimentary
195. Impression smear of mucosa biopsy E. Hepatic
material has been obtained from a patient
with peptic ulcer disease of the stomach. 198. During examination of a patient a
Gram-negative arcuate bent microorgani- doctor should use anatomical division of
sms were detected, urease activity test anterior abdominal wall into regions for
was positive. What microorganisms were more precise diagnostics. How many regi-
detected in the patient? ons can abdomen be divided into?
A. Helicobacter A. 9
B. Spirochete B. 8
C. Spirilla C. 6
D. Leptospira D. 5
E. Treponema E. 4
196. A patient after disrupted cerebral ci- 199. A child has a wound located posterior
rculation has developed paralysis. Choose to the mastoid process. Bright red blood
the anticholinesterase drug to be prescribed flows from the wound. Damaged are the
in this case: branches of the following artery:
A. Proserin A. A. occipitalis
B. Cordiamin B. A. temporalis superior
C. Aceclidine C. A. maxillaris
D. Methacin D. A. carotis externa
E. Hexamethonium (Benzohexonium) E. A. carotis interna
197. 30 minutes after drinking mango juice 200. When investigating human saliva it is
a child suddenly developed a local swelli- necessary to assess its hydrolytic properti-
ng in the area of the soft palate, which es. What substance should be used as a
impeded swallowing and, eventually, respi- substrate in the process?
ration. Mucosa of the swollen area was
hyperemic and painless. Blood test revealed A. Starch
moderate eosinophilia. Body temperature B. Proteins
was normal. Anamnesis states that the elder C. Fats
sister of the child has been suffering from D. Fiber
bronchial asthma attacks. What kind of E. Amino acids
 MINISTRY OF PUBLIC HEALTH OF UKRAINE

Department of human resources policy, education and science

Testing Board

Student ID Last name

Variant ___________________

Test items for licensing examination

Krok 1
MEDICINE
 General Instruction
Every one of these numbered questions or unfinished statements in
this chapter corresponds to answers or statements endings. Choose the
answer (finished statements) that fits best and fill in the circle with the
corresponding Latin letter on the answer sheet.
ББК 54.1я73
УДК 61

Authors of items: Ananko S.Ya., Antonenko V.P., Bielan S.M., Bielienichev I.F., Blinder O.O.,
Bohatyrova O.V., Boikiv D.P., Bondarenko N.M., Bordiakivska L.H., Brazhnikov A.M., Chekman I.S.,
Cherednyk S.A., Cherkas L.P., Cherkashyna L.P., Danylchuk V.V., Datsko T.V., Deineka S.Ye.,
Demianenko I.A., Diadyk O.O., Duhadko L.M., Dzevulska I.V., Fartushok N.V., Fedoniuk L.Ya.,
Fedorchenko O.V., Fedorchenko O.Ye., Fomenko I.S., Haidash I.S., Hanziy T.V., Herasymovych E.V.,
Hliebova L.Yu., Holod B.V., Horhol N.I., Hrechyn A.B., Hryha I.V., Hrytsyna I.V., Huzik N.M.,
Ivanova A.Y., Ivanova S.A., Ivchenko R.A., Kaptiukh R.P., Karvatsky I.M., Kava T.V., Kazak L.I.,
Khara M.R., Khripkov I.S., Kikhtenko O.V., Kiriakulov H.S., Klishch I.M., Klopotsky H.A.,
Kolesnikova S.V., Kolot E.H., Korolenko H.S., Kratenko H.S., Kratinova M.A., Kriuk Yu.Ya.,
Krushynska T.Yu., Kryshtal M.V., Kukurychkin Ye.R., Kulakov A.Yu., Kulikova N.A., Kyriukhin I.F.,
Linchevska L.P., Lisniak O.I., Luchko I.M., Makovetsky O.V., Maksymchuk T.P., Malyshev S.L.,
Matiushenko P.M., Matveiko L.M., Melnychuk I.B., Meshchyshen I.F., Mikhieieva N.H., Mishchenko A.V.,
Mishchenko A.F., Mishchenko K.M., Mishchenko N.P., Mishyn V.V., Moseichuk I.P., Mozghunov O.V.,
Mruh V.M., Mykula M.M., Naumova O.V., Nikolenko O.H., Obraztsova O.H., Oleshchuk O.M.,
Oliynyk I.Yu., Omelchenko O.D., Opryshko V.I., Ovchynnikov S.O., Papinko I.Ya., Pavliy S.Y.,
Piskunova N.V., Pobihun A.A., Polevyk I.V., Popova L.D., Redko R.P., Romanenko M.I., Romanenko O.V.,
Rosola T.F., Rozghoniuk Yu.D., Rukavyshnikova S.M., Rudnytska O.H., Saiuk N.P., Sas L.M.,
Savchenko N.V., Savenko L.D., Selsky P.R., Semenets P.F., Semeniuk T.M., Serdiuchenko I.Ya.,
Servetnyk M.I., Shanko V.M., Shapoval O.M., Shenderiuk O.P., Shevtsova A.I., Shliakhovenko O.O.,
Shutak V.I., Siedov V.I., Sikoryn Ya.Ya., Skorobohata T.H., Skorobohatova Z.M., Snehir A.H.,
Stebliuk M.V., Stetsenko S.O., Siusarev A.A., Suprunov K.V., Svirsky O.O., Sydorenko I.I., Tarasova K.V.,
Terekhovska O.I., Tkachenko V.P., Tomashova S.A., Tsehelsky A.A., Tuchak O.I., Tusyk O.T.,
Tvorko M.S., Vasylieva A.H., Verbytsky V.V., Verkhova O.O., Vernyhor O.O., Vilkhova I.V.,
Vinnikov Yu.M., Voitsekhovsky V.H., Volobuiev M.A., Vorobets Z.D., Yashchyshyn Z.M.,
Yastremska S.O., Yelsky V.M., Zdykhovsky I.O., Zelenina N.M., Zhulinsky V.O., Zhuravel T.O.,
Zviaholska I.M. and Committees of professional expertise.

Item reviewers. Ananko S.Ya., Basy R.V., Bilash S.M., Deineka S. Ye., Deltsova O.I., Demydova K.Yu.,
Fomina L.V., Hahrin V.V., Haidash I.S., Holovatiuk O.L., Horhol N.I., Kava T.V., Koldunov V.V.,
Korolenko H.S., Kovalchuk L.Ye., Linchevska L.P., Maly K.D., Melnikova O.V., Melnyk N.O.,
Neporada K.S., Nikolenko O. H., Ovchynnikov S. O., Prokofieva N. V., Pushkar M. S., Pykaliuk V. S.,
Salata O.V., Shevelenkova A.V., Shumeiko O.V., Sikora V.Z., Skliarov O.Ya., Skorobohatova Z.M.,
Synytska A.M., Tananakina T.P., Teleshova O.V., Tertyshny S.I., Tkachuk S.S., Trzhetsynsky S.D,
Vinnykov Yu.M., Vorobets Z.D., Yoltukhivsky M.V., Zelenina N.M., Zhadinsky M.V., Zhylinsky V.O.,
Zinkovska L.Ya.

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

The book has been developed for students of medical, pediatric and medical-and-prophylactic
faculties and academic staff of higher medical educational establishments.

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

publication based on expert conclusions (Orders of MPH of Ukraine of 14.08.1998 №251,
of 27.12.1999 №303, of 18.06.2002 №221, of 16.10.2002 №374, of 16.04.2003 №239, of
29.05.2003 №233).

© Copyright Testing Board.

 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
1. A 35-year-old man has been delivered
into a surgical ward with a suppurating
wound in the neck, anterior to the trachea
(previsceral space). If a surgical operation
is not performed urgently, there is a risk of
infection spreading to the:
A. Thoracic cavity - anterior mediastinum
B. Thoracic cavity - middle mediastinum
C. Thoracic cavity - posterior mediastinum
D. Retrovisceral space
E. Interaponeurotic suprasternal space
2. In the life cycle of a cell during mitosis
a natural change in the amount of genetic
material occurs. The DNA doubles at the
following stage:
A. Interphase
B. Prophase
C. Metaphase
D. Anaphase
E. Telophase
3. A woman with seasonal vasomotor rhini-
tis, who works as a train dispatcher and is an
outpatient, should be prescribed an antihi-
staminic drug that does not suppress central
nervous system. Name this drug:
A. Loratadine
B. Dimedrol (Diphenhydramine)
C. Diprazine (Promethazine)
D. Suprastin (Chloropyramine)
E. Tavegyl (Clemastine)
4. During sanitary and bacteriological testi-
ng of water with the membrane filter techni-
que there were revealed two red coloni-
es on the membrane filter (Endo medium)
through which 500 ml of water was filtered.
Calculate the coli index and coli titer of this
water:
A. 4 and 250
B. 2 and 500
C. 250 and 4
D. 500 and 2
E. 250 and 2
5. Protective function of saliva is based
on several mechanisms, including the
presence of enzyme that has bacterici-
dal action and causes lysis of complex
capsular polysaccharides of staphylococci
and streptococci. Name this enzyme:
A. Lysozyme
B. Alpha-amylase
C. Oligo-1,6-glucosidase
D. Collagenase
E. Beta-glucuronidase
6. What kind of muscle contraction occurs
in an upper limb during an attempt to lift a
load beyond one’s strength?
1
A. Isometric
B. Isotonic
C. Auxotonic
D. Phasic
E. Single
7. The patient’s pyramids of the medulla
oblongata are damaged by tumor growth.
As a result the conduction of nervous
impulses will be impaired in the following
pathway:
A. Tr. corticospinalis
B. Tr. corticonuclearis
C. Tr. corticopontinus
D. Tr. dentatorubralis
E. Tr. spinocerebellaris
8. A patient complains of pain in the upper
umbilical region. On palpation there is a
mobile painful intestine. What intestine is
being palpated by the doctor?
A. Transverse colon
B. Jejunum
C. Duodenum
D. Ileum
E. Sigmoid colon
9. After inoculation of investigated material
(feces) on 1% alkaline peptone water and
8-hour-long incubation in the thermostat
under 37o C there is growth of pale bluish
film observed. Such cultural properties are
characteristic of the agent of the following
disease:
A. Cholera
B. Plague
C. Typhoid fever
D. Paratyphoid A fever
E. Dysentery
10. Histological investigation of the uterine
scrape of the 45-year-old woman with di-
sturbed ovarian menstrual cycle revealed
increased number of endometrial glands,
some of which are serrated, while others are
dilated and cyst-like. Make the diagnosis:
A. Endometrial cystic glandular hyperplasia
B. Placental polyp
C. Atypical endometrial hyperplasia
D. Glandular endometrial polyp
E. Endometrial adenocarcinoma
11. A pregnant woman with several mi-
scarriages in anamnesis is prescribed a
therapy that includes vitamin preparati-
ons. What vitamin facilitates carrying of a
pregnancy?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Alpha-tocopherol
B. Folic acid
C. Cyanocobalamin
D. Pyridoxal phosphate
E. Rutin
12. A patient has decreased concentrati-
on of magnesium ions that are requi-
red for ribosomes connection to granular
endoplasmic reticulum. This condition is
known to disturb the process of protein
biosynthesis. Disturbance occurs at the
following stage:
A. Translation
B. Transcription
C. Replication
D. Amino acids activation
E. Processing
13. A patient with chronic heart failure
presents with increased blood viscosity.
Capillaroscopy detected damage to the
vessel walls of the microcirculation system.
What disorder is possible in the given case?
A. Blood ”sludge” phenomenon
B. Thrombosis
C. Embolism
D. Arterial hyperemia
E. Venous hyperemia
14. A 3-year-old boy with pronounced
hemorrhagic syndrome has no anti-
hemophilic globulin A (factor VIII) in the
blood plasma. Hemostasis has been impai-
red at the following stage:
A. Internal mechanism of prothrombinase
activation
B. External mechanism of prothrombinase
activation
C. Conversion of prothrombin to thrombin
D. Conversion of fibrinogen to fibrin
E. Blood clot retraction
15. Paronychia of the patient’s little finger
was complicated with phlegmon of the hand
and forearm. In this case the suppuration
had spread through the:
A. Vagina synovialis communis mm.
flexorum
B. Vagina tendinis m. flexor pollicis longi
C. Canalis carpalis
D. Vagina tendinis m. flexor carpi radialis
E. Interfascial compartments
16. During cholecystectomy besides a.
cystyca another artery was pulled into the
ligature. Ligation of this artery resulted in
right-sided necrosis of the liver which led to
the death of the patient. What artery was
mistakenly ligated along with a. cystyca?
2
A. Ramus dexter a. hepatica propria
B. А. hepatica communis
C. А. gasro-duodenalis
D. Ramus sinister a. hepatica propria
E. А. pancreato-duodenalis sup
17. During treatment with bismuth
preparations a patient with syphilis
developed gray spots on his oral mucosa
and nephropathy symptoms. What drug is
used as an antidote to bismuth preparations
poisoning?
A. Unithiol
B. Nalorphine
C. Bemegride
D. Naloxone
E. Methylene blue
18. A patient with periodontitis of the lower
molar came to the doctor. It was determi-
ned that the inflammatory process spread to
the lymph nodes. What lymph nodes were
the first to be affected by the inflammatory
process?
A. Submandibular
B. Lateral cervical
C. Anterior cervical
D. Submental
E. Facial
19. A 63-year-old man suffers from
esophageal carcinoma, presents with
metastases into the mediastinal lymph
nodes and cancerous cachexia. What
pathogenetic stage of neoplastic process is
observed in the patient?
A. Progression
B. Promotion
C. Transformation
D. Initiation
E. -
20. A person is in a room with air
temperature of 38o C and relative air humi-
dity of 50%. What type of heat transfer
ensures maintenance of constant body core
temperature under these conditions?
A. Evaporation
B. Radiation
C. Conduction and convection
D. Convection
E. -
21. A patient has hoarseness of voice. Duri-
ng laryngoscopy a gray-white larynx tumor
with papillary surface has been detected.
Microscopic investigation has shown the
following: growth of connective tissue
covered with multilayer, strongly kerati-
nized pavement epithelium, no cellular
atypia. What is the most likely diagnosis?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Papilloma
B. Fibroma
C. Polyp
D. Angioma
E. Angiofibroma
22. A shepherd, who tended to the flock of
sheep with his dogs, gradually developed
pain in the chest and bloody expectorati-
ons. X-ray revealed spheric helminth larvae
in the patient’s lungs. Specify the helminth
that could be the causative agent of this di-
sease:
A. Echinococcus
B. Hymenolepis nana
C. Diphylobotrium latum
D. Fasciola hepatica
E. Taenia solium
23. A 67-year-old patient with cli-
nical diagnosis of chronic bronchitis,
pneumosclerosis, and cardiopulmonary
decompensation has the biopsy material
taken from the suspicious area in his ri-
ght bronchus mucosa. Cellular and tissue
atypism along with pearly bodies can be
histologically detected. What pathologic
process is characterized by the described
histological changes?
A. Squamous cell carcinoma of bronchus
with keratinization
B. Polypoid chronic bronchitis
C. Bronchiectasis
D. Acute bronchitis
E. Squamous cell metaplasia of bronchial
mucosa
24. A child with point mutation presents
with absence of glucose 6-phosphatase,
hypoglycemia, and hepatomegaly. What
pathology are these signs characteristic of?
A. Von Gierke’s disease (Glycogen storage
disease type I)
B. Cori’s disease (Glycogen storage disease
type III)
C. Addison’s disease (Primary adrenal
insufficiency)
D. Parkinson’s disease
E. McArdle’s disease (Glycogen storage
disease type V)
25. At the 2-3 day after the gastric resection
the patient’s intestinal peristalsis failed to
restore. What should the patient be prescri-
bed to stimulate the function of his gastroi-
ntestinal tract?
3
A. Proserin
B. Platyphyllin
C. Cyclodol (Trihexyphenidyl)
D. Atropine
E. Dithyline (Suxamethonium chloride)
26. Examination of the patient with
traumatic brain injury revealed that he has
lost the ability to discern the movement
of an object on the skin. What part of the
cerebral cortex is damaged?
A. Posterior central gyrus
B. Occipital lobe
C. Parietal lobe
D. Frontal lobe
E. Anterior central gyrus
27. Blood test of the patient revealed
albumine content of 20 g/l and increased
activity of lactate dehydrogenase isoenzyme
5 (LDH5). These results indicate disorder of
the following organ:
A. Liver
B. Kidneys
C. Heart
D. Lungs
E. Spleen
28. Section shows significant enlargement
of the patient’s right kidney. There is a
nephrolith at the place of incision. Renal
pelvic lumen is distended with accumulating
urine. Renal parenchyma is acutely thinned
out. What is the most correct diagnosis?
A. Hydronephrosis
B. Pyelectasis
C. Hydroureteronephrosis
D. Renal cyst
E. Nephroblastoma
29. A patient demonstrates sharp decrease
of pulmonary surfactant activity. This condi-
tion can result in:
A. Alveolar tendency to recede
B. Decreased airways resistance
C. Decreased work of expiratory muscles
D. Increased pulmonary ventilation
E. Hyperoxemia
30. After a case of cold the patient
developed a lacrimation disorder. This di-
sorder was caused by functional disturbance
of the following autonomic ganglion:
A. Pterygopalatine
B. Ciliary
C. Otic
D. Submandibular
E. Sublingual
31. A patient is diagnosed with diabetic
coma. Blood sugar is 18,44 mmol/l. What
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
glucose-regulating drug should be prescri-
bed in the given case?
A. Rapid-acting insulin
B. Intermediate-acting insulin
C. Long-acting insulin
D. Biguanide
E. Sulfonylurea derivative
32. A man came into the admission room
with complaints of edemas, rapid heart rate,
dyspnea, and cyanotic mucosal tunics. He
was diagnosed with chronic heart failure.
What drug should be prescribed to improve
the patient’s general state?
A. Digoxin
B. Papaverine hydrochloride
C. Mesaton (Phenylephrine)
D. Cordiamin
E. Nitroglycerine
33. Exposure to colchicine resulted in
metaphase plate of a human containing 23
chromosomes more than it is normal. Name
this mutation:
A. Polyploidy
B. Aneuploidy
C. Polyteny
D. Inversion
E. Translocation
34. A 30-year-old man complains of
suffocation, heaviness in the chest on the
right, general weakness. Body temperature
is 38,9o C . Objectively the right side of
the chest lags behind the left side during
respiration. Pleurocentesis yielded exudate.
What is the leading factor of exudation in
the patient?
A. Increased permeability of the vessel wall
B. Increased blood pressure
C. Hypoproteinemia
D. Erythrocyte aggregation
E. Decreased resorption of pleural fluid
35. A 46-year-old woman suffering from
cholelithiasis developed jaundice. Her urine
became dark yellow, while feces are light-
colored. What substance will be the most
increased in concentration in the blood
serum in this case?
A. Conjugated bilirubin
B. Unconjugated bilirubin
C. Biliverdine
D. Mesobilirubin
E. Urobilinogen
36. A traumatology unit received a pati-
ent with crushed muscular tissue. What bi-
ochemical indicator of urine will be raised
in this case?
4
A. Creatinine
B. Total lipids
C. Glucose
D. Mineral salts
E. Uric acid
37. A 30-year-old woman first developed
pain, swelling, and skin redness in the area
of joints about a year ago. Provisional di-
agnosis is rheumatoid arthritis. One of the
likely causes of this disease is change in the
structure of the following connective tissue
protein:
A. Collagen
B. Mucin
C. Myosin
D. Ovalbumin
E. Troponin
38. A 15-year-old teenager complains of
lack of air, general weakness, palpitati-
ons. Heart rate is 130/min., BP is 100/60
mm Hg. ECG: QRS complex has normal
shape and duration. The number of P waves
and ventricular complexes is equal, T wave
merges with P wave. What type of cardiac
arrhythmia is observed in the teenager?
A. Sinus tachycardia
B. Sinus extrasystole
C. Atrial fibrillation
D. Atrial thrill
E. Paroxysmal atrial tachycardia
39. A patient complaining of dizziness, thi-
rst, difficult swallowing, and impaired visi-
on of close objects has addressed a doctor.
Objectively: respiratory rate is increased,
pupils are dilated, general agitation, talkati-
veness, though the speech is indistinct. BP is
110/70 mm Hg, heart rate is 110/min. Given
symptoms can indicate overdosage of the
following drug:
A. Atropine
B. Morphine
C. Ephedrine
D. Aminazine
E. Caffeine
40. On autopsy of a 40-year-old woman,
who had been suffering from rheumatoid
arthritis, her liver is found to be dense
and enlarged. On dissection its tissue is
red-brown colored, with enlarged follicles
resembling semi-transparent grayish-white
granules. What is the most likely pathologi-
cal process?
A. Sago spleen
B. Sugar-coated spleen
C. Lardaceous spleen
D. Splenic hyalinosis
E. Porphyry spleen
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
41. On autopsy the dissector determined
that the lungs are enlarged, pale, soft, do not
deflate, crunch when cut. Microscopically
there are dilated alveolar ducts, alveolar
septa are thin, and signs of intracapillary
sclerosis are observed. What pulmonary di-
sorder are these presentations characteristic
of?
A. Emphysema
B. Pneumosclerosis
C. Pneumothorax
D. Atelectasis
E. Pneumonia
42. During removal of the hyperplastic
thyroid gland of a 47-year-old woman,
the parathyroid gland was damaged.
One month after the surgery the pati-
ent developed signs of hypoparathyroi-
dism: frequent convulsions, hyperreflexia,
laryngospasm. What is the most likely cause
of the patient’s condition?
A. Hypocalcemia
B. Hyponatremia
C. Hyperchlorhydria
D. Hypophosphatemia
E. Hyperkalemia
43. On examination the patient presents
with hirsutism, moon-shaped face, stretch
marks on the abdomen. BP is 190/100 mm
Hg, blood glucose is 17,6 mmol/l. What
pathology is such clinical presentation
characteristic of?
A. Adrenocortical hyperfunction
B. Hyperthyroidism
C. Hypothyroidism
D. Gonadal hypofunction
E. Hyperfunction of the insular apparatus
44. Histological specimen of the ovary
shows large hollow structures. Primary
oocyte within these structures is surrounded
with transparent membrane and radiati-
ng crown and is situated in the cumulus
oophorus, the wall is made of follicular cell
layer and theca. What ovarian structure can
be characterized by these morphological
features?
A. Mature (tertiary) follicle
B. Primordial follicle
C. Primary follicle
D. Сorpus luteum
E. Corpus atreticum
45. Histological specimen demonstrates
a parenchymal organ with cortical
and medullary substances. The cortical
substance is composed of bands of epitheli-
al cells with capillary blood vessels between
them. The bands form three zones. The
medullary substance consists of сhromaffin
5
cells and venous sinusoids. What organ can
be characterized by these morphological
features?
A. Adrenal gland
B. Kidney
C. Lymph node
D. Thymus
E. Thyroid gland
46. A child with suspected colienteritis was
delivered to the infectious diseases hospital.
Colibacillus was obtained from the child’s
feces. How to determine whether this baci-
llus is of pathogenic variety?
A. Agglutination reaction with serum 0
B. Based on its biochemical properties
C. By means of bacteriophage typing
D. Microscopy of stained smears
E. Based on the nature of its growth in Endo
medium
47. A patient ungergoes right-sided
pulmonectomy due to lung cancer. Name
the anatomical structures of the right lung
radix (downward order):
A. Bronchus, artery, veins
B. Artery, bronchus, veins
C. Artery, veins, bronchus
D. Veins, artery, bronchus
E. Veins, bronchus, artery
48. In a township there was registered
an outbreak of hepatitis, which was attri-
buted to water supply. What hepatitis virus
could be the cause of the outbreak in this
township?
A. Hepatitis E virus
B. Hepatitis C virus
C. Hepatitis D virus
D. Hepatitis G virus
E. Hepatitis B virus
49. A 64-year-old woman presents with di-
sturbed fine motor function of her fingers,
marked muscle rigidity, and tremor. The
neurologist diagnosed her with Parkinson’s
disease. What brain structures are damaged
resulting in this disease?
A. Substantia nigra
B. Thalamus
C. Red nuclei
D. Cerebellum
E. Reticular formation
50. Due to prolonged taking of a drug the
patient can develop osteoporosis, gastric
mucosal erosions, hypokalemia, sodium
and water retention, and decreased blood
content of corticotropine. Specify this drug:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Prednisolone
B. Hydrochlorothiazide
C. Digoxin
D. Indometacin
E. Reserpine
51. Nitrogen is being excreted from the
body mainly as urea. When activity of a
certain enzyme in the liver is low, it results
in inhibition of urea synthesis and nitrogen
accumulation in blood and tissues. Name
this enzyme:
A. Carbamoyl phosphate synthetase
B. Aspartate aminotransferase
C. Urease
D. Amylase
E. Pepsin
52. After pancreatic surgery the patient
developed hemorrhagic syndrome with di-
sturbed 3rd stage of blood clotting. What
will be the most likely mechanism of the
hemostatic disorder?
A. Fibrinolysis activation
B. Decrease of prothrombin synthesis
C. Decrease of fibrinogen synthesis
D. Qualitative abnormalities of fibri-
nogenesis
E. Fibrin-stabilizing factor deficiency
53. A patient with jaundice has high
total bilirubin that is mainly indirect
(unconjugated), high concentration of
stercobilin in the feces and urine. The level
of direct (conjugated) bilirubin in the blood
plasma is normal. What type of jaundice can
be suspected?
A. Hemolytic
B. Parenchymal (hepatic)
C. Mechanical
D. Neonatal
E. Gilbert’s disease
54. Histological specimen shows organ
parenchyma to consist of lymphoid tissue
that forms lymph nodules; the nodules
are located diffusely and have a central
artery. What anatomical structure has such
morphological characteristics?
A. Spleen
B. Tonsil
C. Lymph node
D. Thymus
E. Red bone marrow
55. During fibergastroscopy of a patient wi-
th ulcer disease of the stomach, the mucosal
biopsy material is taken from the area of
an ulcer. Impression smear is prepared from
the biopsy material and stained by Gram
method; the rest of the biopsy material is
tested for urease activity. Microscopy of the
6
impression smear revealed gram-negative
spiral-shaped microorganisms, urease acti-
vity test is positive. What bacteria were
detected?
A. Helycobacter pylori
B. Spirilla minor
C. Shigella flexneri
D. Treponema pallidum
E. Campylobacter jeuni
56. A patient suffering from gout was
prescribed allopurinol. What pharmacologi-
cal property of allopurinol provides
therapeutic effect in this case?
A. Competitive inhibition of xanthine oxi-
dase
B. Acceleration of nitrogen-containing
substances excretion
C. Acceleration of pyrimidine nucleotides
catabolism
D. Deceleration of pyrimidine nucleotides
salvage
E. Acceleration of nucleic acids synthesis
57. A woman, who has been suffering from
marked hypertension for 15 years, has lately
developed dyspnea, palpitations, slightly
decreased systolic pressure, while diastolic
pressure remains the same. What is the main
mechanism of heart failure development in
this case?
A. Cardiac overload due to increased
vascular resistance
B. Cardiac overload due to increased blood
volume
C. Damage to the myocardium
D. Disorder of impulse conduction in the
myocardium
E. Dysregulation of cardiac function
58. Old burial ground for animal refuse,
which has not been in use for the last 50
years, is planned to be given for housing
development. However, the soil analysis
detected viable spores of a causative agent
of an extremely dangerous disease. What
microorganism is the most likely to remain
in the soil for such a long period of time?
A. Bacillus anthracis
B. Francisella tularensis
C. Brucella abortus
D. Yersinia pestis
E. Mycobacterium bovis
59. Blood of the patients with diabetes
mellitus shows increased content of free
fatty acids. Name the most likely cause of
this:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк 7

A. Increased activity of adipose triglyceride

lipase A. Medulla oblongata
B. Accumulation of palmitoyl-CoA in B. Diencephalon
cytosol C. Mesencephalon
C. Activation of ketone bodies utilization D. Spinal cord
D. Activation of apoА1, apoА2, and apoА4 E. Cerebral cortex
apolipoprotein synthesis
E. Decreased activity of plasma 65. Investigation of an isolated cardi-
phosphatidylcholine-cholesterol- ac myocyte determined that it does not
acyltransferase generate excitation impulses automati-
cally, which means this cardiac myocyte
60. During autopsy of a man, who had been was obtained from the following cardiac
suffering from mitral stenosis, the lungs are structure:
revealed to be dense and brown-colored.
What pathologic process had occurred in A. Ventricles
the lungs? B. Sinoatrial node
C. Atrioventricular node
A. Hemosiderosis D. His’ bundle
B. Hemochromatosis E. Purkinje’s fibers
C. Jaundice
D. Hemomelanosis 66. To lose some weight a woman has been
E. Lipofuscinosis limiting the amount of products in her di-
et. 3 months later she developed edemas
61. Examination of the coronary arteries and her diuresis increased. What dietary
revealed atherosclerotic plaques with calci- component deficiency is the cause of this?
nosis that close the arterial opening by 1/3.
In the muscle there are numerous whiti- A. Proteins
sh layers of connective tissue. Name the B. Fats
process detected in the myocardium: C. Carbohydrates
D. Vitamins
A. Diffuse cardiosclerosis E. Minerals
B. Tiger heart
C. Postinfarction cardiosclerosis 67. The patients with organic brain disorder
D. Myocarditis can take the following drug to improve their
E. Myocardial infarction memory:

62. T-lymphocytes are determined to be A. Piracetam

affected with HIV. In this case viral enzyme B. Nitrazepam
reverse transcriptase (RNA-dependent C. Medazepam
DNA-polymerase) catalyzes the synthesis D. Diazepam
of: E. Caffeine

A. DNA based on the viral RNA matrix
B. Viral RNA based on the DNA matrix
C. Viral protein based on the viral RNA
matrix
D. Viral DNA based on the DNA matrix
E. Informational RNA based on the viral
protein matrix
63. A woman with dense area in her
mammary gland came to a surgeon. To mi-
nimize the trauma to the mammary gland
lobule during the operation the surgeon
should make the incision:
A. Radially
B. Vertically
C. Transversely
D. Arcuately
E. -
64. Electrical activity of neurons is being
measured. They fire prior to and at the
beginning of inhalation. Where are these
neurons situated?
68. A 40-year-old man developed skin
redness and swelling in the neck area,
where eventually a small abscess appeared.
On section the focus is dense and yellow-
green colored. In the purulent masses there
are white granules. Histologically there
are fungal druses, plasma and xanthome
cells, and macrophages detected. Specify
the most correct etiological name of this
pathological process:
A. Actinomycosis
B. Furuncle
C. Carbuncle
D. Syphilis
E. Leprosy
69. In preparation for business trip abroad
the doctor was prescribed a histoschi-
zontocidal antimalarial drug as a personal
means of disease prevention. What drug was
given to the doctor?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Chingamin
B. Biseptol (Co-trimoxazole)
C. Doxycycline
D. Mefloquine
E. Quinine
70. A patient, who has been suffering from
bronchial asthma for a long time, developed
acute respiratory failure. What is the main
mechanism of pathology development in
this case?
A. Obstructive disorders of pulmonary
ventilation
B. Restrictive disorders of pulmonary venti-
lation
C. Pulmonary blood supply disturbance
D. Pulmonary enzyme system disturbance
E. Decreased elasticity of the pulmonary
tissue
71. A 40-year-old woman has undergone
thyroidectomy. Histological study of thyroid
gland found the follicles to be of different
size and contain foamy colloid, follicle epi-
thelium is high and forms papillae, there is
focal lymphocytic infiltration in the stroma.
Diagnose the thyroid gland disease:
A. Basedow’s disease
B. Hashimoto’s thyroiditis
C. Riedel’s thyroiditis
D. De Quervain’s disease
E. Nodular goiter
72. A patient has been hospitalized
with provisional diagnosis of virus B
hepatitis. Serological reaction based on
complementation of antigen with antibody
chemically bound to peroxidase or alkaline
phosphatase has been used for disease di-
agnostics. What is the name of the applied
serological reaction?
A. Enzyme-linked immunosorbent assay
B. Radioimmunoassay technique
C. Immunofluorescence test
D. Complement fixation test
E. Immobilization test
73. Due to blood loss the circulating blood
volume of a patient decreased. How will it
affect the blood pressure in this patient?
A. Systolic and diastolic pressure will
decrease
B. Only systolic pressure will decrease
C. Only diastolic pressure will decrease
D. Systolic pressure will decrease, while
diastolic will increase
E. Diastolic pressure will decrease, while
systolic will increase
74. A bacteriological laboratory tests
canned meat for botulinum toxin. Extract
of the tested material and ABE botulinum
8
antitoxin serum was introduced into the test
group of mice; the control group of mice
received the extract without antibotulinic
serum. What serological reaction was used?
A. Neutralization
B. Precipitation
C. Complement binding
D. Opsonophagocytic
E. Double immunodiffusion
75. A 50-year-old man is diagnosed with
ischemic heart disease and cardiosclerosis
with hypertensive syndrome. What drug
should be prescribed in this case?
A. Metoprolol
B. Acetylsalicylic acid
C. Corglycon
D. Strophanthine
E. Potassium chloride
76. Poisoning caused by mercury (II) chlori-
de (corrosive sublimate) occurred in the
result of safety rules violation. In 2 days the
patient’s diurnal diuresis became 620 ml.
The patient developed headache, vomiti-
ng, convulsions, dyspnea; moist crackles are
observed in the lungs. Name this pathology:
A. Acute renal failure
B. Chronic renal failure
C. Uremic coma
D. Glomerulonephritis
E. Pyelonephritis
77. Autopsy of a 9-year-old child shows
numerous irregular defects of varying depth
with uneven margins and gray-white films
tightly attached to the underlying tissue on
the rectal mucosa of the body. What disease
can be suspected?
A. Dysentery
B. Salmonellosis
C. Cholera
D. Typhoid fever
E. Amebiasis
78. A man presents with glomerular fi-
ltration rate of 180 ml/min., while norm is
125±25 ml/min. The likely cause of it is the
decreased:
A. Plasma oncotic pressure
B. Effective filtration pressure
C. Hydrostatic blood pressure in the
glomerular capillaries
D. Renal blood flow
E. Permeability of the renal filter
79. A young man came to a hospital with
complaints of disturbed urination. Exami-
nation of his external genitalia revealed
the urethra to be split on the top, with uri-
ne flowing out of this opening. What type
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
of external genitalia maldevelopment is
observed in this case?
A. Epispadia
B. Phimosis
C. Hermaphroditism
D. Paraphimosis
E. Hypospadias
80. A 10-year-old child had cut his leg wi-
th a glass shard, when playing, and was
delivered to the outpatient department
to receive antitetanus serum. To prevent
development of anaphylactic shock the
serum was introduced by Bezredka method.
This method of organism hyposensitization
is based on the following mechanism:
A. Binding of mast cell-fixed IgE
B. Blocking of mast cell mediators synthesis
C. Stimulation of immune tolerance to
antigen
D. Stimulation of antigen-specific IgG2
E. Stabilization of mast cell membranes
81. A 38-year-old man, who has
been suffering from systemic lupus
erythematosus for 3 years, developed di-
ffuse renal lesions accompanied by massi-
ve edemas, marked proteinuria, hyperli-
pidemia, and dysproteinemia. What is
the most likely mechanism of proteinuria
develoment in this case?
A. Autoimmune damage to the nephrons
B. Inflammatory damage to the nephrons
C. Ischemic damage to the tubules
D. Increased blood proteins
E. Morbid affection of the urinary tracts
82. During experiment a part of the brain
was extracted, which resulted in asynergy
and dysmetria development in the test ani-
mal. What part of the brain was extracted in
the animal?
A. Cerebellum
B. Frontal lobe
C. Parietal lobe
D. Mesencephalon
E. Reticulum
83. A woman with polyarticular rheumatoid
arthritis was prescribed a non-steroidal
antiinflammatory drug - diclofenac sodium.
After the patient has been taking it for some
time, her concomitant disease exacerbated,
which forced the doctor to cancel the
prescription of this drug. What concomi-
tant disease could necessitate cancellation
of this drug prescription?
9
A. Ulcer disease
B. Ischemic heart disease
C. Diabetes mellitus
D. Essential hypertension
E. Bronchial asthma
84. Histologic preparation stained wi-
th orcein demonstrates from 40 to 60
fenestrated elastic membranes within the
middle coat of the vessel. Name this vessel:
A. Elastic artery
B. Muscular artery
C. Mixed type artery
D. Muscular vein
E. Nonmuscular vein
85. A woman with the III (В), Rh (-) blood
group gave birth to a child with the II (А)
blood group. The child is diagnosed with
hemolytic disease of newborn caused by
rhesus incompatibility. What blood group
and Rh are likely in the father?
A. II (А), Rh (+)
B. I (0), Rh (+)
C. III (B), Rh (+)
D. I (0), Rh (-)
E. II (A), Rh (-)
86. A 40-year-old woman with Cushi-
ng’s disease presents with steroid di-
abetes. On biochemical examination she has
hyperglycemia and hypochloremia. What
process activates in the first place in such
patients?
A. Gluconeogenesis
B. Glycogenolysis
C. Glucose reabsorption
D. Glucose transportation into a cell
E. Glycolysis
87. A 40-year-old prisoner died of
tuberculosis in the corrective labor camp.
Autopsy of the body revealed deformation
and diminishing of both lung apices; in the
both upper lobes there are multiple cavi-
ties with dense walls 2-3 mm thick; in the
lower lung lobes there are disseminated
foci of caseous necrosis varying from 5 mm
to 2 cm in diameter. Diagnose the type of
tuberculosis:
A. Secondary fibro-cavitary tuberculosis
B. Secondary fibrous-focal tuberculosis
C. Hematogenous macrofocal pulmonary
tuberculosis
D. Primary tuberculosis, primary affect
development
E. Secondary cirrhotic tuberculosis
88. A 7-year-old boy died of acute
posthemorrhagic anemia caused by profuse
hemorrhage in the gastrointestinal tract.
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк 10

Postmortem study revealed the followi-

ng: macroscopically there were acutely A. Radiating
enlarged various groups of the lymph nodes, B. Visceral
thymomegaly, hepatosplenomegaly, and C. Phantom
bright red bone marrow; microscopically D. Protopathic
there was hypercellular bone marrow wi- E. Epicritic
th monomorphic infiltrations composed of
blasts and diffuse-focal tumor infiltrations 93. During regular check-up a child is
in the liver, spleen, lymph nodes, brain determined to have interrupted minerali-
substance and tunics. Make the diagnosis: zation of the bones. What vitamin defici-
ency can be the cause?
A. Acute lymphoblastic leukemia
B. Acute myeloblastic leukemia A. Calciferol
C. Acute undifferentiated leukemia B. Riboflavin
D. Acute monoblastic leukemia C. Tocopherol
E. Acute plasmablastic leukemia D. Folic acid
E. Cobalamin
89. Autopsy of a man, who served on a
nuclear submarine, revealed the followi- 94. On examination the patient was
ng pathologies: bone marrow atrophy determined to have strong, balanced, inert
(panmyelophthisis), anemia, leukopenia, type of higher nervous activity according to
Pavlov’s classification. What temperament
thrombocytopenia, lymphocytes disi-
ntegration in the lymph nodes, spleen, according to Hippocrates is it?
gastrointestinal lymphatic system, and A. Phlegmatic
hemorrhages into the adrenal glands. What B. Sanguine
disease had developed in this case? C. Choleric
A. Acute radiation sickness D. Melancholic
B. Decompression sickness E. -
C. Acute leukemia 95. A specimen shows an organ covered wi-
D. Acute anemia th connective tissue capsule with trabeculae
E. Vibration disease radiating inward the organ. The organ’s
90. After sensitization a test animal recei- cortex contains lymph nodules; there are
ved subcutaneously a dose of antigen. At medullary cords made of lymphoid cells.
the site of injection a fibrinous inflammati- What organ is under study?
on developed with alteration of vessel walls, A. Lymph node
basal substance, and fibrous structures of B. Thymus
connective tissue. The inflammation took C. Spleen
form of mucoid and fibrinoid degeneration, D. Red bone marrow
fibrinoid necrosis. What immune response E. Tonsils
occurred in the test animal?
96. Brain autopsy revealed an edema,
A. Immediate hypersensitivity hyperemia, and small hemorrhages in
B. Delayed hypersensitivity the medulla oblongata. Microscopically
C. Transplantation immune reaction chromatolysis, hydropia and nerve cell
D. Normergic reaction necrosis are observed; within the cytoplasm
E. Granulomatosis of hippocampal nerve cells there are eosi-
91. Preoperative examination revealed nophilic structures (Negri bodies) detected.
prothrombin deficiency in the blood of the What diagnosis corresponds with the descri-
patient. What drug should be preliminarily bed morphological signs?
prescribed to mitigate blood loss in the pati- A. Rabies
ent during the surgery? B. Meningococcal meningitis
A. Vicasol (Menadione) C. Encephalitis
B. Thrombin D. Encephalomyelitis
C. Aminocapronic acid E. Brucellosis
D. Phenylin (Phenindione) 97. A married couple came for a genetic
E. Contrykal (Aprotinin) counseling. The husband suffers from
insulin-independent diabetes mellitus, while
92. A patient complaining of pain in the left the wife is healthy. What is the probability of
shoulder-blade region has been diagnosed their child developing insulin-independent
with miocardial infarction. What kind of diabetes mellitus?
pain does the patient have?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Higher than in the population
B. The same as in the population
C. Lower than in the population
D. 100%
E. 50%
98. A 46-year-old patient suffering from
ulcer disease of the stomach is diagnosed
with rheumatoid arthritis. What antii-
nflammatory drug would be the most advi-
sable in this case?
A. Celecoxib
B. Prednisolone
C. Analgin (Metamizole)
D. Promedol (Trimeperidine)
E. Paracetamol
99. Electron micrograph of the kidney
shows fenestrated endothelium lying on the
basement membrane; the external surface
of the membrane has adjacent dendritic epi-
thelial cells. What do these structures form
in the kidney?
A. Filtration barrier
B. Juxtaglomerular apparatus
C. Distal nephron
D. Henle’s loop
E. Proximal nephron
100. A worker of an agricultural enterprise
had been suffering from an acute disease
with aggravating intoxication signs, whi-
ch resulted in his death. On autopsy: the
spleen is enlarged, flaccid, dark cherry-red
on section, yields excessive pulp scrape. Soft
meninges of the fornix and base of the brain
are edematous and saturated with blood
(”cardinal’s cap”). Microscopically: serous-
hemorrhagic inflammation of meninges and
cerebral tissues. Make the diagnosis:
A. Anthrax
B. Tularemia
C. Plague
D. Cholera
E. Brucellosis
101. A woman suffers from tonsillitis
complicated with retropharyngeal abscess
that is localized in the spatium retrovi-
scerale. In this case the suppurative process
can spread to the:
A. Mediastinum posterius
B. Spatium interaponeuroticum suprasternale
C. Mediastinum anterius
D. Spatium pretracheale
E. Spatium interscalenum
102. A patient with chronic bronchitis was
prescribed a drug with mucolytic action.
Name this drug:
11
A. Ambroxol
B. Anaprilin (Propranolol)
C. Atropine sulfate
D. Magnesium sulfate
E. Paracetamol
103. A patient suffers from acute cardi-
opulmonary failure with pulmonary edema.
What diuretic should be prescribed in the
given case?
A. Furosemide
B. Triamterene
C. Spironolactone
D. Dichlothiazidum (Hydrochlorothiazide)
E. Diacarb (Acetazolamide)
104. Therapeutics unit of a hospital recei-
ved a man suffering from ulcer disease of
the stomach with hyperacidity. Which of the
listed group of drugs must be used as a part
of the complex therapy of this patient?
A. Histamine H2 -receptor antagonists
B. Calcium channel blockers
C. Nonsteroidal antiinflammatory drugs
D. Steroidal antiinflammatory drugs
E. Histamine H1 -receptor antagonists
105. A 45-year-old woman gave birth to
a boy with cleft maxilla (cleft lip and
palate). On additional examination there
are significant disturbances of the boy’s
nervous, cardiovascular, and visual systems.
Karyotype investigation allowed diagnosing
the patient with trisomy 13. What syndrome
is present in the boy?
A. Patau
B. Down
C. Kleinfelter
D. Turner
E. DiGeorge
106. Pathologic material (mucosal excreti-
on from the nasal passages) obtained from
a patient provisionally diagnosed with
influenza was delivered to the virological
laboratory. What quick test allows detecti-
ng specific viral antigen in the investigated
material?
A. Direct and indirect immunofluorescence
(IF)
B. Direct and indirect enzyme-linked
immunosorbent assay (ELISA)
C. Hemagglutination inhibition assay (HAI)
D. Reverse indirect haemagglutination (RI-
HA)
E. Radioimmunoassay (RIA)
107. A 5-year-old child is diagnosed
with Bruton syndrome (X-linked
agammaglobulinemia) that manifests itself
in severe clinical course of bacterial
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
infections and absence of B lymphocytes
and plasma cells. What changes of
immunoglobulin content can be observed in
blood serum of the child with immunodefi-
ciency?
A. Decreased IgA, IgM
B. Increased IgA, IgM
C. Decreased IgD, IgE
D. Increased IgD, IgE
E. No changes
108. A 37-year-old man, who was worki-
ng in a caisson, after being lifted to the
surface suddenly developed signs of acute
cerebral circulation disturbance and loss of
consciousness. Several days later he died.
On autopsy in the left cerebral hemisphere
there was detected a gray soft irregular
focus 5х6х3,5 cm in size. What process had
occurred in the brain?
A. Ischemic stroke
B. Hemorrhagic infarction
C. Abscess
D. Cyst
E. Tumor
109. A short-term physical load resulted in
reflex increase of heart rate and systemic
arterial pressure in a person. What receptor
activation was the most contributory to
inducing the pressor reflex?
A. Proprioceptors of the working muscles
B. Vascular chemoreceptors
C. Vascular volume receptors
D. Vascular baroreceptors
E. Hypothalamic thermoreceptors
110. During experiment a skeletal muscle is
being stimulated with a series of electrical
impulses. What type of muscular contracti-
on will develop, if each following impulse
occurs within the relaxation period after the
previous single contraction of the muscle?
A. Incomplete tetanus
B. Smooth tetanus
C. Series of single contractions
D. Muscle contracture
E. Asynchronous tetanus
111. Depression and emotional di-
sturbances result from the lack of
noradrenaline, serotonin, and other bi-
ogenic amines in the brain. Their content
in the synapses can be increased through
administration of antidepressants that inhi-
bit the following enzyme:
12
A. Monoamine oxidase
B. Diamine oxidase
C. L-amino acids oxidase
D. D-amino acid oxidase
E. Phenylalanine 4-monooxygenase
112. A 2-year-old child presents with acute
psychomotor retardation, vision and heari-
ng impairment, sharp enlargement of the
liver and spleen. The child is diagnosed wi-
th hereditary Niemann-Pick disease. What
genetic defect is the cause of this disease?
A. Sphingomyelinase deficiency
B. Glucose 6-phosphatase deficiency
C. Amylo-1,6-glucosidase deficiency
D. Acid lipase deficiency
E. Xanthine oxidase deficiency
113. Clinical presentations of a woman
allowed provisionally diagnosing her with
X polysomy. Cytogenetic method is applied
to clarify the diagnosis. The diagnosis will
be confirmed if the patient’s karyotype is:
A. 47, ХХХ
B. 48, XXXY
C. 48, XXYY
D. 47, XXY
E. 46, XX
114. During dehelmintization there was a
3,5-meter-long tapeworm produced from
the patient’s intestine.There are 4 suckers
and hooks on the tapeworm’s scolex.
Mature segments of the tapeworm are
immobile and have up to 12 uterine
branches. What disease is it?
A. Teniasis
B. Echinococcosis
C. Beef tapeworm infection
D. Diphyllobothriasis
E. Opisthorchiasis
115. A patient presents with steatorrhea.
This disorder can be linked to disturbed
supply of the intestine with the following
substances:
A. Bile acids
B. Carbohydrates
C. Tripsin
D. Chymotrypsin
E. Amylase
116. Cytochrome oxidase is a hemeprotein
that is an end component of the mi-
tochondrial respiratory chain. What reacti-
on is catalyzed with this enzyme?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Transfer of reduced equivalents to
molecular oxygen
B. Cytochrome synthesis
C. Transfer of reduced equivalents to ubiqui-
none
D. Cytochrome splicing
E. Adenosine triphosphate synthesis
117. A 16-year-old girl fainted when she tri-
ed to quickly change her position from hori-
sontal to vertical. What caused the loss of
consciousness in the girl?
A. Decreased venous return
B. Increased venous return
C. Increased central venous pressure
D. Decreased oncotic plasma pressure
E. Increased arterial pressure
118. An unconscious patient was delivered
by ambulance to the hospital. On objective
examination the patient was found to have
no reflexes, periodical convulsions, irregular
breathing. After laboratory examination the
patient was diagnosed with hepatic coma.
Disorders of the central nervous system
develop due to the accumulation of the
following metabolite:
A. Ammonia
B. Urea
C. Glutamine
D. Bilirubin
E. Histamine
119. A patient complains of acute pain
attacks in the right lumbar region. During
examination the nephrolithic obturation of
the right ureter in the region between its
abdominal and pelvic segments has been
detected. What anatomical boundary exists
between those two segments?
A. Linea terminalis
B. Linea semilunaris
C. Linea arcuata
D. Linea transversa
E. Linea inguinalis
120. After mushroom poisoning the pati-
ent developed signs of acute hepatic fai-
lure leading to his death. On autopsy the
liver is diminished, flaccid; the capsule
is wrinkled; the tissue is ochre-yellow on
section. Microscopically: fatty degeneration
of hepatocytes, necrotic central segments
of the hepatic lobes. These changes are
characteristic of:
A. Massive progressive necrosis
B. Fatty hepatosis
C. Acute exudative hepatitis
D. Acute productive hepatitis
E. Hepatolenticular degeneration
121. Blood test of an athlete shows the
13
following: erythrocytes - 5, 5 · 1012 /l,
hemoglobin - 180 g/l, leukocytes - 7 ·
109 /l, neutrophils - 64%, basophils - 0,5%,
eosinophils - 0,5%, monocytes - 8%,
lymphocytes - 27%. These values primari-
ly indicate the stimulation of:
A. Erythropoiesis
B. Leukopoiesis
C. Lymphopoiesis
D. Granulocytopoiesis
E. Immunogenesis
122. 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:
A. Calcium ion entry
B. Calcium ion exit
C. Potassium ion exit
D. Potassium ion entry
E. Calcium and potassium ion exit
123. As a result of past encephalitis, a man
has developed an increase in cerebrospinal
fluid pressure in the right lateral ventricle.
What can be the cause of this condition?
A. Closure of the right interventricular
foramen
B. Closure of the left interventricular
foramen
C. Atresia of the tubus medullaris
D. Atresia of the sylvian aqueduct
E. Atresia of the fourth ventricle foramina
124. A patient with pneumonia has body
temperature of 39,2oC . What cells are the
main producers of endogenous pyrogen that
had caused such temperature rise?
A. Monocytes
B. Eosinophils
C. Neutrophils
D. Endotheliocytes
E. Fibroblasts
125. A patient is diagnosed with compressi-
on fracture of the lumbar vertebra. The pati-
ent presents with acutely increased lumbar
lordosis. What ligament was damaged in
this patient resulting in such deformation
of vertebral column curvature?
A. Anterior longitudinal ligament
B. Posterior longitudinal ligament
C. Yellow ligament
D. Iliolumbar ligament
E. Interspinal ligament
126. Gram-positive spore-forming baci-
lli were extracted in anoxic environment
from the patient’s wound contaminated
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
with soil. Cultivation on a blood-glucose
agar resulted in growth of the colonies
surrounded with hemolysis zone. What
agent was extracted from the wound?
A. Сlostridium perfringens
B. Staphylococcus aureus
C. Clostridium botulinum
D. Escherichia coli
E. Pseudomonas aeruginosa
127. The patient’s ECG shows that in the
second standard lead from the extremities
the P waves are positive, their amplitude is
0,1 mV (norm is 0,05-0,25 mV), duration -
0,1 seconds (norm is 0,07-0,10 seconds). It
can be concluded that the following process
occurs normally in the cardiac atria:
A. Depolarization
B. Repolarization
C. Activation
D. Contraction
E. Relaxation
128. Autopsy of a patient, who died of bi-
lateral bronchopneumonia, shows in the
left lung lower lobe a cavity 5 cm in di-
ameter, filled with liquid yellowish-white
substance. What complication of the pati-
ent’s pneumonia had developed?
A. Abscess
B. Gangrene
C. Granuloma
D. Sequestrum
E. Tuberculoma
129. A patient, who has been subsisting
exclusively on polished rice, has developed
polyneuritis due to thiamine deficiency.
What substance is an indicator of such avi-
taminosis, when it is excreted with urine?
A. Pyruvic acid
B. Malate
C. Methylmalonic acid
D. Uric acid
E. Phenyl pyruvate
130. It is known that pentose-phosphate
pathway actively functions in the
erythrocytes. What is the main function of
this metabolic pathway in the erythrocytes?
A. Counteraction to lipid peroxidation
B. Activation of microsomal oxidation
C. Neutralization of xenobiotics
D. Oxidation of glucose into lactate
E. Increase of lipid peroxidation
131. Pupil dilation occurs when a person
steps from a light room into a dark one.
What reflex causes such a reaction?
14
A. Sympathetic unconditioned reflex
B. Sympathetic conditioned reflex
C. Metasympathetic reflex
D. Parasympathetic unconditioned reflex
E. Parasympathetic conditioned reflex
132. A patient complaining of heartburn has
undergone biopsy of the gastric mucosa. In
the sample there are numerous cells with
oxyphilic cytoplasm in the glandular epi-
thelium. Name these cells:
A. Exocrine parietal cells
B. Exocrine chief cells
C. Mucous cells
D. Epithelial cells
E. Endocrine cells
133. Inherited diseases, such as
mucopolysaccharidoses, manifest in
metabolic disorders of connective tissue,
bone and joint pathologies. The sign of this
disease is the excessive urinary excretion of
the following substance:
A. Glycosaminoglycans
B. Amino acids
C. Glucose
D. Lipids
E. Urea
134. A woman was delivered to a
gynecological unit with signs of acute
abdomen and suspected extrauterine
pregnancy with oviduct rupture. Where will
the blood accumulate in this case?
A. Rectouterine pouch
B. Vesicouterine pouch
C. Retrovesical pouch
D. Right lateral canal
E. Left lateral canal
135. A patient had a trauma that caused
dysfunction of motor centers regulating
activity of head muscles. These centers can
normally be located in the following area of
the cerebral cortex:
A. Inferior part of the precentral gyrus
B. Superior part of the precentral gyrus
C. Supramarginal gyrus
D. Superior parietal lobule
E. Angular gyrus
136. At the post-mortem examination the
stomach of a patient with renal failure was
found to have a yellow-brown coating on
the thickened mucosa. The coating was fi-
rmly adhering to its surface and had si-
gnificant thickness. Microscopy revealed
congestion and necrosis of mucosal and
submucosal layers, fibrin presence. What is
the most likely diagnosis?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк 15

A. Diphtheritic gastritis heat processing. What helminthiasis was the

B. Croupous gastritis case?
C. Phlegmonous gastritis
D. Catarrhal gastritis A. Trichinosis
E. Corrosive gastritis B. Taeniarhynchosis
C. Teniasis
137. Cystinuria manifests itself in a D. Echinococcosis
human as cystine stones in the kidneys E. Alveococcosis
(homozygous individuals) or increased
cystine content in the urine (heterozygous 142. A person with vitamin A deficiency
individuals). Cystinuria is a monogenic di- develops twilight vision disturbance. Name
sorder. Determine the type of interaction the cells that fulfill this photoreceptor
between the genes of cystinuria and normal function:
urine cystine excretion: A. Rod cells
A. Semidominance B. Horizontal cells of retina
B. Epistasis C. Bipolar neurons
C. Complete dominance D. Cone cells
D. Complementarity E. Ganglionic nerve cells
E. Codominance 143. Presented is the biopsy material of an
138. A patient with obliterating organ consisting of saccule-shaped rounded
atherosclerosis has undergone sympathectomy structures of varying size. Inside these
of the femoral artery in the area of femoral structures there is a gel-like non-cellular
triangle. What type of arterial hyperemia substance - colloid; structure walls are
was developed in the patient due to this composed of one layer of cuboidal cells that
surgery? lay on the basement membrane. Between
the saccules there is connective tissue with
A. Neuroparalytic vessels. Name this organ:
B. Reactive
C. Metabolic A. Thyroid gland
D. Neurotonic B. Pancreas
E. Functional C. Parotid gland
D. Thymus
139. On bronchoscopy there is a polypoid E. Parathyroid gland
growth 1,0 cm in diameter with ulcer in
its center in the upper lobe of the right 144. A 26-year-old woman with bronchitis
lung. Histological investigation revealed a has been administered a broad spectrum
tumor composed of lymphocyte-like cells antibiotic as a causal treatment drug. Speci-
with hyperchromic nuclei, the cells form fy this drug:
layers and bands. What is the most likely A. Doxycycline
tumor type? B. Interferon
A. Undifferentiated small cell carcinoma C. BCG vaccine
B. Undifferentiated large cell carcinoma D. Ambroxol
C. Squamous cell carcinoma E. Dexamethasone
D. Adenocarcinoma 145. Water affects the mucosa of lower nasal
E. Glandular squamous cell carcinoma passages resulting in diving reflex. This
140. The brain trauma unit received a pati- responce manifests itself as:
ent with damaged greater wing of the A. Reflex apnea
sphenoid bone. The fracture line crosses B. Reflex dyspnea
the spinous foramen of the sphenoid. What C. Reflex hyperpnea
vessel was damaged? D. Cough
A. Middle meningeal artery E. Bronchial spasm
B. Superficial temporal artery 146. Examination of a 56-year-old woman
C. Lateral pterygoid artery with a history of type 1 diabetes revealed
D. Anterior deep temporal artery a disorder of protein metabolism that
E. Posterior deep temporal artery is manifested by aminoacidemia in the
141. In one of Polessye regions there was laboratory blood test values, and clini-
an outbreak of helminthiasis manifested by cally by the delayed wound healing and
cramps and facial edemas. The developed decreased synthesis of antibodies. Which
preventive measures in particular included of the following mechanisms causes the
ban for eating infested pork even after development of aminoacidemia?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Increased proteolysis
B. Albuminosis
C. Decrease in concentration of blood amino
acids
D. Increase in plasma oncotic pressure
E. Increase in low-density lipoproteins level
147. One of the factors that cause obesity is
the inhibition of fatty acids oxidation due to:
A. Low carnitine content
B. Impaired phospholipid synthesis
C. Excessive consumption of fatty foods
D. Choline deficiency
E. Lack of carbohydrates in the diet
148. Streptomycin and other aminoglycosi-
des prevent the joining of formyl-
methionyl-tRNA by bonding with the 30S
ribosomal subunit. This effect leads to di-
sruption of the following process:
A. Translation initiation in procaryotes
B. Translation initiation in eucaryotes
C. Transcription initiation in procaryotes
D. Transcription initiation in eucaryotes
E. Replication initiation in procaryotes
149. In hot weather ventilators are often
used to normalize the microclimate in the
heated rooms. It leads to intensified heat
transfer from the human body by means of:
A. Convection
B. Conduction and convection
C. Conduction
D. Radiation
E. Evaporation
150. During gastric resection the patient
received mixed anesthesia with tubocurarin
chloride muscle relaxant; to restore
spontaneous respiration the patient recei-
ved proserin. What pharmacological group
does this drug belong to?
A. Cholinesterase inhibitors
B. Angiotensin-converting-enzyme inhibi-
tors
C. Calcium channel blockers
D. Muscarinic antagonists
E. Muscarinic agonists
151. A 67-year-old man 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 fracti-
on (LDL). What type of hyperlipoprotei-
nemia is observed in the patient?
A. Hyperlipoproteinemia type IIa
B. Hyperlipoproteinemia type I
C. Hyperlipoproteinemia type IIb
D. Hyperlipoproteinemia type IV
E. Cholesterol, hyperlipoproteinemia
16
152. To treat bronchitis the patient was
prescribed a beta-lactam antibiotic. Its
mechanism of action is based on inhibition
of murein production, which results in death
of the causative agent. Name this drug:
A. Penicillin G Sodium Salt
B. Bijochinol (Quinine bismuth iodide)
C. Ciprofloxacin
D. Azithromycin
E. Streptomycin
153. Cell membrane rest potential changed
from -85 to -90 mV. It can be caused by
activation of the following cell membrane
channels:
A. Potassium
B. Sodium
C. Potassium and sodium
D. Calcium
E. Potassium and calcium
154. Ionizing radiation or vitamin E defici-
ency affect the cell by increasing lysosome
membrane permeability. What are the possi-
ble consequences of this pathology?
A. Partial or complete cell destruction
B. Intensive protein synthesis
C. Intensive energy production
D. Restoration of cytoplasmic membrane
E. Formation of maturation spindle
155. A 22-year-old woman ate some
seafood. 5 hours later her torso and distal
parts of her limbs developed small itchy
papules which were partially fused together.
One day later the rash disappeared
spontaneously. Specify the hypersensitivi-
ty mechanism underlying these changes:
A. Atopy (local anaphylaxis)
B. Systemic anaphylaxis
C. Cellular cytotoxicity
D. Immune complex hypersensitivity
E. Antibody-dependent cell-mediated
cytolysis
156. During acute hemorrhage the body
loses not only fluid but also electrolytes.
What substance solution can be used as a
simple blood substitute?
A. Sodium chloride
B. Sodium bromide
C. Albumin
D. Sodium nucleotide
E. Calcium chloride
157. A patient has been admitted to the
contagious isolation ward with signs of
jaundice caused by hepatitis virus. Which of
the symptoms given below is strictly specific
for hepatocellular jaundice?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Increase of ALT, AST level
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholemia
E. Urobilinuria
158. In a body of a 37-year-old woman,
who died with signs of pulmonary edema,
there was detected acute deformation of
the aortic valve: it is shortened, thickened,
ulcerated, has areas of stone-like density.
On its external surface there are large, up
to 2 cm in diameter, thrombotic plaques.
Left ventricle wall is 2,2 cm thick. Cardiac
muscle is dull, matt, and flaccid. What type
of endocarditis corresponds with described
alterations of the aortic valve?
A. Ulcerative polypoid endocarditis
B. Diffuse endocarditis
C. Acute verrucous endocarditis
D. Recurrent verrucous endocarditis
E. Fibroplastic endocarditis
159. Students study the stages of
gametogenesis. They analyze a cell wi-
th haploid number of chromosomes, whi-
th each chromosome consisting of two
chromatids. The chromosomes are located
in the equatorial plane of the cell. Such si-
tuation is typical of the following stage of
meiosis:
A. Metaphase of the second division
B. Metaphase of the first division
C. Anaphase of the first division
D. Anaphase of the second division
E. Prophase of the first division
160. A 38-year-old woman developed a
bronchial asthma attack. Which of the li-
sted bronchial spasmolytics is effective
for emergency aid and belongs to beta-2-
adrenergic agonists?
A. Salbutamol
B. Adrenaline
C. Ipratropium bromide
D. Platyphyllin
E. Atropine
161. After emotional upset a woman has
been suffering from disturbed sleep for
several days. What soporific drug would be
preferable for this type of insomnia?
A. Nitrazepam
B. Phenobarbital
C. Ethaminal sodium (Pentobarbital)
D. Barbamylum (Amobarbital)
E. Chloral hydrate
162. During training session in the
laboratory the students were performing
spirography on themselves. What indicator
CANNOT be measured with this method?
17
A. Functional residual capacity
B. Vital capacity
C. Respiratory minute volume
D. Respiration rate
E. Maximal breathing capacity
163. In the South and Central Ameri-
ca there can be found a species of
trypanosomes that is the causative agent of
Chagas disease. What animal is the infecti-
on carrier specific to this disease?
A. Triatomine bug
B. Cockroach
C. Tsetse fly
D. Mosquito
E. Gnat
164. A 54-year-old woman was brought to
the emergency department after a car acci-
dent. A traumatologist diagnosed her with
multiple fractures of the lower extremities.
What kind of embolism is the most likely to
develop in this case?
A. Adipose
B. Tissue
C. Thromboembolism
D. Gaseous
E. Air
165. A 30-year-old man with diabetes
mellitus type I was hospitalized. The
patient is comatose. Laboratory tests
revealed hyperglycemia and ketonemia.
What metabolic disorder can be detected
in this patient?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Respiratory alkalosis
E. Acid-base balance is normal
166. Typical manifestations of food poisoni-
ng caused by C. botulinum are double visi-
on, abnormal functioning of the swallowing
and breathing. These symptoms develop as
the result of:
A. Exotoxin action
B. Enterotoxin action
C. Enterotoxic shock development
D. Activation of adenylate cyclase
E. Pathogen adhesion to the enterocyte
receptors
167. An infant, who was on synthetic
formula feeding, developed signs of vitamin
B1 deficiency. What reactions does this vi-
tamin take part in?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Keto acids oxidative decarboxylation
B. Amino acids transamination
C. Amino acids decarboxylation
D. Proline hydroxylation
E. Redox reactions
168. A 30-year-old woman developed the si-
gns of virilism (body hair growth, balding
temples, disturbed menstrual cycle). What
hormone can cause this condition when
hyperproduced?
A. Testosterone
B. Estriol
C. Relaxin
D. Oxytocin
E. Prolactin
169. A histological specimen shows signifi-
cant amount of mucous connective tissue
(Wharton’s jelly), vessels, as well as residual
yolk and allantois. Name this organ:
A. Umbilical cord
B. Esophagus
C. Ureter
D. Urethra
E. Vermiform appendix
170. On examination of a 6-year-old chi-
ld the doctor noticed grayish film on
the child’s tonsils. Microscopy of the
smears stained by Neisser method detected
there Corynebacterium diphtheriae. What
morphologic feature was the most indicati-
ve for determining the type of the agent?
A. Polar placement of volutin granules
B. Localization of the causative agent within
macrophages
C. Spores that exceed cells in diameter
D. Fence-like position of the agent’s cells
E. Presence of the capsule
171. During the sports competition a boxer
received a strong blow to the abdomen,
which caused a knockout due to a brief
drop in blood pressure. What physiological
mechanisms are the cause of this condition?
A. Stimulation of parasympathetic nerves
B. Alteration of transcapillary exchange
C. Ischemia of the central nervous system
D. Abrupt change in body fluid volume
E. Stimulation of sympathetic nerves
172. After a severe stress the patient
presents with eosinopenia in the blood test.
In this case the decreased number of eosi-
nophils can explain changes in the level of
the following hormones:
18
A. Glucocorticoids
B. Adrenaline
C. Insulin
D. Mineralocorticoids
E. Vasopressin
173. 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 in this case:
A. Neoplastic erythroid hyperplasia
B. Iron-deficiency
C. B12 -deficiency
D. Hypoxia
E. Acidosis
174. Deaf parents with genotypes DDee and
ddEE gave birth to a child with normal
hearing. Specify the interaction of D and
E genes:
A. Complementary interaction
B. Complete dominance
C. Epistasis
D. Polymery
E. Overdominance
175. Corticosteroid hormones regulate the
adaptation processes of the body as a
whole to environmental changes and ensure
the maintenance of internal homeostasis.
What hormone activates the hypothalamo-
pituitary-adrenal axis?
A. Corticoliberin
B. Somatoliberin
C. Somatostatin
D. Corticostatin
E. Thyroliberin
176. A patient with signs of emotional labi-
lity that result in troubled sleep has been
prescribed nitrazepam. Specify the sleep-
inducing mechanism of this drug:
A. GABA-ergic system activation
B. Blockade of opiate receptors
C. Inhibition of stimulating amino acids
D. H1 -histamine receptors stimulation
E. Supression of serotonergic neurotransmi-
ssion
177. A 50-year-old inpatient during exami-
nation presents with glucosuria and blood
glucose of 3,0 mmol/l, which are the most
likely to be caused by:
A. Renal disorder
B. Diabetes insipidus
C. Myxedema
D. Essential hypertension
E. Pellagra
178. A man is suffering from diarrhea. In
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
summer he spent his vacation in the south
at the sea coast. Bacteria with the following
properties were detected in his feces: gram-
negative curved mobile monotrichous baci-
lli that do not produce spores or capsules.
They are undemanding to nutrient medium
but require alkaline reaction (рН - 8,5-9,5).
Described are the agents of the following
enteric infection:
A. Cholera
B. Shigellosis
C. Typhoid fever
D. Colienteritis
E. Pseudotuberculosis
179. A pregnant woman was detected to
have IgM to rubella virus. An obstetrician-
gynecologist recommended therapeutic
abortion due to the high risk of teratogenic
affection of the fetus. Detection of IgM was
of great importance as it is these specific
immunoglobulins that:
A. Indicate recent infection
B. Penetrate placental barrier
C. Have the largest molecular weight
D. Are associated with anaphylactic reacti-
ons
E. Are the main factor of antiviral protection
180. During examination of a teenager
with xanthomatosis the family history of
hypercholesterolemia is revealed. What
transportable lipids are increased in
concentration in case of such a disease?
A. Low-density lipoproteins
B. Chylomicrons
C. Very low-density lipoproteins
D. High-density lipoproteins
E. Intermediate-density lipoproteins
181. On examination the patient is found to
have low production of adrenocorticotropic
hormone. How would this affect production
of the other hormones?
A. Decrease adrenocorticotropic hormones
synthesis
B. Decrease hormone synthesis in the
adrenal medulla
C. Decrease insulin synthesis
D. Increase sex hormones synthesis
E. Increase thyroid hormones synthesis
182. Parkinson’s disease is caused by
disturbance of dopamine synthesis.
What brain structure synthesizes this
neurotransmitter?
19
A. Substantia nigra
B. Globus pallidus
C. Corpora quadrigemina
D. Red nuclei
E. Hypothalamus
183. Determining a patient’s blood group
with monoclonal test-reagents revealed
positive agglutination reaction to anti-A
and anti-B reagents, and negative reacti-
on to anti-D. What blood group does this
patient have?
A. IV (АВ) Rh (-)
B. II (А) Rh (+)
C. III (В) Rh (-)
D. IV (АВ) Rh (+)
E. I (0) Rh (+)
184. A patient visited a dentist to extract a
tooth. After the tooth had been extracted,
bleeding from the tooth socket continued
for 15 minutes. Anamnesis states that the
patient suffers from active chronic hepatitis.
What phenomenon can extend the time of
hemorrhage?
A. Decrease of fibrinogen content in blood
B. Thrombocytopenia
C. Hypocalcemia
D. Increased activity of anticoagulation
system
E. Decrease of albumine content in blood
185. During ascent into mountains a person
develops increased respiration rate and
rapid heart rate. What is the cause of these
changes?
A. Decrease of O2 partial pressure
B. Increase of CO2 partial pressure
C. Increase of blood pH
D. Increase of nitrogen content in air
E. Increase of air humidity
186. To stop the bleeding the patient
was prescribed a direct coagulant. Duri-
ng introduction of the solution the patient
was complaining of pain along the vein, hot
sensation, and palpitations. Name the drug
that causes such symptoms:
A. Calcium chloride
B. Hirudine
C. Ergocalciferol
D. Pentoxyl
E. Streptokinase
187. A student, whose educational achi-
evements throughout the semester were
poor, feels emotionally tense during the
final test. What is the primary cause that
induced leading mechanism of emotional
tension in this case?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк
A. Lack of information
B. Tight time
C. Ttight time and lack of energy
D. Lack of energy
E. Lack of energy and information
188. A young family came for a genetic
counseling to identify the father of their chi-
ld. The husband insists that the child does
not resemble him at all and cannot possibly
be his. Polymerase chain reaction method
for person identification is based on the
following:
A. Gene amplification
B. Nucleotide deletion
C. Genetic recombination
D. Missense mutation
E. Transduction
189. A 52-year-old man presents with fever
and pain in the joints. Both of his fi-
rst metatarsophalangeal articulations are
deformed, swollen, and reddened. Blood
urea is high. The patient is diagnosed wi-
th gout. What is the main developmental
factor in the pathogenesis of this disease?
A. Hyperuricemy
B. Argininosuccinic aciduria
C. Hyperazotemia
D. Hyperaminoacidemia
E. Citrullinuria
190. A 67-year-old man was delivered to the
cardiology unit with complaints of periodi-
cal pain in the heart, dyspnea after even
insignificant physical exertion, cyanosis, and
edemas. ECG revealed additional contracti-
ons of the heart ventricles. Name this type
of rhythm disturbance:
A. Extrasystole
B. Bradycardia
C. Tachycardia
D. Flutter
E. Fibrillation
191. During narcosis the patient developed
a risk of cerebral edema. What drug should
be administered in this case?
A. Furosemide
B. Dopamine
C. Phenazepam
D. Triamterene
E. Sodium bromide
192. A patient with pulmonary tuberculosis
is prescribed the most effective anti-
tuberculous antibiotic. Name this drug:
20
A. Rifampicin
B. Tetracycline
C. Streptocide
D. Furasolidone
E. Bactrim (Co-trimoxazole)
193. During surgery performed in the
abdominal cavity a surgeon located li-
gament of liver stretching from anterior
abdominal wall (navel) to inferior surface
of liver. What ligament is it?
A. Round ligament of the liver
B. Falciform ligament of the liver
C. Coronary ligament of the liver
D. Venous ligament of the liver
E. Triangular ligament of the liver
194. On examination of a patient with di-
sease onset 5 days ago the doctor suspected
tularemia and prescribed the patient tularin
intracutaneously. What is the purpose of this
drug administration in the patient?
A. Allergy diagnostics
B. Prevention
C. Treatment
D. Treatment evaluation
E. Prognosis for the disease
195. A patient developed increased blood
content of HCO3− against the background
of repeated and uncontrollable vomiti-
ng. What will be the leading mechanism
in compensation of developed acid-base
imbalance?
A. Decreased pulmonary ventilation
B. Increased pulmonary ventilation
C. Increased renal reabsorption of bi-
carbonate
D. Increased renal reabsorption of ammonia
E. -
196. A 13-year-old boy presents wi-
th eczematous rashes on his shins and
torso. Anamnesis states cases of otitis,
pneumonia, and furuncles in the patient.
Blood test: platelets - 70 · 109 /l, low acti-
vity of T helper and T suppressor cells,
low IgM, with normal IgA and IgG. What
immunodeficient disease does this boy
have?
A. Wiskott-Aldrich syndrome
B. Louis-Bar syndrome (Ataxia-
telangiectasia)
C. Severe combined immunodeficiency
(Swiss type)
D. DiGeorge syndrome
E. Chediak-Higashi syndrome
197. During the exam a student was unable
to correctly answer all the questions in his
question card, which was accompanied by
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2017 рiк 21

the reddening of his face and hot sensati- 199. Due to trauma the patient presents wi-
on. What type of arterial hyperemia did the th disturbed function of the parotid gland.
student develop in this case? What nerve ensures its secretion function?
A. Neurotonic A. N. petrosus minor
B. Metabolic B. N. petrosus major
C. Postischemic C. N. petrosus profundus
D. Pathologic D. N. auricularis minor
E. Neuroparalytic E. N. auricularis major
198. An injured person with wound of 200. A patient developed pyoinflammatory
the anterior cervical region presents with process of periodontal tissues caused by
hemorrhage. The outflowing blood is dark. activation of the microorganisms inherent
What vessel is damaged? in the body, which are a part of oral mucosal
microflora. What type of infection is it?
A. V. jugularis anterior
B. V. jugularis externa A. Autoinfection
C. V. jugularis interna B. Exogenous infection
D. A. carotis externa C. Reinfection
E. A. thyroidea superior D. Superinfection
E. Relapse
INSTRUCTIONAL BOOK
Testing Board

TEST ITEMS FOR LICENSING EXAMINATION: KROK 1. MEDICINE.

Kyiv. Testing Board.

(English language).

Approved to print 04.05/№256 Paper size 60х84 1/8

Offset paper. Typeface. Times New Roman Cyr. Offset print.
Conditional print pages 20. Accounting publishing pages 24.
Issue. 2673 copies.
List of abbreviations

A/G Albumin/globulin ratio HR Heart rate

A-ANON Alcoholics anonymous IDDM Insulin dependent diabetes mellitus
ACT Abdominal computed tomography IFA Immunofluorescence assay
ADP Adenosine diphosphate IHD Ischemic heart disease
ALT Alanin aminotranspherase IU International unit
AMP Adenosine monophosphate LDH Lactate dehydrogenase
AP Action potential MSEC Medical and sanitary expert committee
ARF Acute renal failure NAD Nicotine amide adenine dinucleotide
AST Aspartat aminotranspherase NADPH Nicotine amide adenine dinucleotide
ATP Adenosine triphosphate phosphate restored
BP Blood pressure NIDDM Non-Insulin dependent diabetes mellitus
bpm Beats per minute PAC Polyunsaturated aromatic carbohydrates
C.I. Color Index PAS Periodic acid & shiff reaction
CBC Complete blood count pCO2 CO2 partial pressure
CHF Chronic heart failure pO2 CO2 partial pressure
CT Computer tomography pm Per minute
DIC Disseminated intravascular coagualtion Ps Pulse rate
DCC Doctoral controlling committee r roentgen
DM-2 Non-Insulin dependent diabetes mellitus RBC Red blood count
DTP Anti diphtheria-tetanus vaccine RDHA Reverse direct hemagglutination assay
ECG Electrocardiogram Rh Rhesus
ESR Erythrocyte sedimentation rate (R)CFT Reiter's complement fixation test
FC Function class RIHA Reverse indirect hemagglutination assay
FAD Flavin adenine dinucleotide RNA Ribonucleic acid
FADH2 Flavin adenine dinucleotide restored RR Respiratory rate
FEGDS Fibro-esphago-gastro-duodenoscopy S1 Heart sound 1
FMNH2 Flavin mononucleotide restored S2 Heart sound 2
GIT Gastrointestinal tract TU Tuberculin unit
GMP Guanosine monophosphate U Unit
Hb Hemoglobin USI Ultrasound investigation
HbA1c Glycosylated hemoglobin V/f Vision field
Hct Hematocrit WBC White blood count
HIV Human immunodeficiency virus X-ray Roentgenogram
 MINISTRY OF PUBLIC HEALTH OF UKRAINE

Department of human resources policy, education and science

Testing Board

Student ID Last name

Variant ___________________

Test items for licensing examination

Krok 1
MEDICINE
 General Instruction
Every one of these numbered questions or unfinished statements in
this chapter corresponds to answers or statements endings. Choose the
answer (finished statements) that fits best and fill in the circle with the
corresponding Latin letter on the answer sheet.
54.1 73
61

Authors of items: Andrieieva V.F., Andriishyn O.P., Arnautova L.V., Basiy R.V., Batyshcheva N.Yu.,
Bevziuk D.O., Bielan S.M., Bielienichev I.F., Bilets M.V., Blinder O.O., Bodnar Ya.Ya., Boiko O.V.,
Bondarenko Yu.I., Bordiakivska L.H., Chehodar A.Ya., Cherkashyna L.P., Cherkashyna O.Ye.,
Chernenko H.P., Chernobai L.V., Chernovska N.V., Chystolinova L.I., Danylchuk V.V., Datsko T.V.,
Davydenko I.S., Deineka S.Ye., Demianenko I.A., Diachyshyna L.V., Diadyk O.O., Dieltsova O.I.,
Dutchak U.M., Dzevulska I.V., Fartushok N.V., Hanziy T.V., Harets V.I., Herasymovych E.V., Herush I.V.,
Hetsko O.I., Holieva N.V., Holota L.H., Holotiuk L.Ye., Holovatiuk O.L., Honcharova N.H.,
Horianova N.O., Hryhorenko V.K., Hrytsenko L.Z., Hrytsyna I.V., Hubina-Vakulyk H.I., Hurmak I.S.,
Husakova L.V., Ivanova N.I., Karvatsky I.M., Khara M.R., Khodorovsky H.I., Komissarov I.V.,
Korolenko H.S., Kratinova M.A., Kryshtal M.V., Kryvetsky V.V., Kucheriavchenko M.O., Kukovska I.L.,
Kukurychkin Ye.R., Kulish A.S., Kulitka E.F., Ladutko S.V., Lemke M.O., Linchevska L.P., Loitra A.O.,
Lozynska R.V., Lutsiuk M.B., Luzin V.I., Lyzyn D.V., Maksymchuk T.P., Minukhin V.V.,
Mishchenko A.V., Mishchenko K.M., Mozghunov O.V., Mruh V.M., Nakonechna O.A., Navnyko T.S.,
Nikolaienko I.V., Nikolenko O.H., Nykytiuk H.P., Oblyvach A.V., Obraztsova O.H., Oleshchuk O.M.,
Oliynyk I.Yu., Opryshko V.I., Ovchynnikov S.O., Pasholok S.P., Pelykh V.Ye., Piddubniak Yu.H.,
Piskunova N.V., Prokofieva N.V., Rodynsky O.H., Romanenko O.V., Rukavyshnikova S.M., Saiuk N.P.,
Salata O.V., Samoilovych I.M., Savchenko N.V., Selsky P.R., Semeniuk T.M., Senchiy V.M.,
Serdiuchenko I.Ya., Servetnyk M.I., Shanko V.M., Shcherbak L.F., Shcherbakov S.M., Shenderiuk O.P.,
Shevtsova A.I., Skorobohatova Z.M., Skrebkova O.Yu., Smirnova T.V., Snehir A.H., Stebliuk M.V.,
Stetsenko S.O., Stklianina L.V., Svirsky O.O., Sydorchuk I.Y., Symachova A.V., Sytnikova V.O.,
Taldykin P.Ye., Tarasenko L.M., Tertyshna O.V., Tertyshny S.I., Tkachenko V.P., Tumansky V.O.,
Tusyk O.T., Tymoshenko S.H., Vasiuta V.S., Vasylchenko V.M., Vasylenko I.V., Vasylieva A.H.,
Vasylyk V.M., Vernyhor O.O., Voitsekhovsky V.H., Voloshyn M.A., Vorobets Z.D., Vysotsky I.Yu.,
Yashchenko A.M., Yasinsky V.I., Yastremska S.O., Yeshchenko V.Yu., Yoltukhivsky M.M.,
Yushkova V.V., Zakharchuk O.I., Zdykhovsky I.O., Zelenina N.M., Zhadinsky M.V., Zhulinsky V.O.,
Ziatkovska N.Ye. and Committees of professional expertise.

Item reviewers. Ananko S.Ya., Basy R.V., Bilash S.M., Deineka S. Ye., Deltsova O.I.,
Demydova K.Yu., Fomina L.V., Hahrin V.V., Haidash I.S., Holovatiuk O.L., Horhol N.I., Kava T.V.,
Koldunov V.V., Korolenko H.S., Kovalchuk L.Ye., Linchevska L.P., Maly K.D., Melnikova O.V.,
Melnyk N.O., Neporada K.S., Nikolenko O.H., Ovchynnikov S.O., Prokofieva N.V., Pushkar M.S.,
Pykaliuk V.S., Salata O.V., Shevelenkova A.V., Shumeiko O.V., Sikora V.Z., Skliarov O.Ya.,
Skorobohatova Z.M., Synytska A.M., Tananakina T.P., Teleshova O.V., Tertyshny S.I., Tkachuk S.S.,
Trzhetsynsky S.D, Vinnykov Yu.M., Vorobets Z.D., Yoltukhivsky M.V., Zelenina N.M., Zhadinsky M.V.,
Zhylinsky V.O., Zinkovska L.Ya.

The b k i cl de e i em f e a lice i g i eg a ed e ami a i K k 1. Medici e a d

further use in teaching.

The book has been developed for students of medical, pediatric and medical-and-prophylactic
faculties and academic staff of higher medical educational establishments.

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

publication based on expert conclusions (Orders of MPH of Ukraine of 14.08.1998 №251,
of 27.12.1999 №303, of 18.06.2002 №221, of 16.10.2002 №374, of 16.04.2003 №239, of
29.05.2003 №233).

C igh Te i g B a d.
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
1. A 40-year-old woman on examinati-
on presents with intensified basal metabolic
rate. What hormone present in excess leads
to such condition?
A. Triiodothyronine
B. Thyrocalcitonin
C. Glucagon
D. Aldosterone
E. Somatostatin
2. Autopsy of a woman revealed the followi-
ng morphologic changes: stenosis of the
atrioventricular opening, mitral insuffici-
ency. Histologically there are focal cardi-
osclerosis and ”blooming” Aschoff nodules
in the myocardium. What is the most likely
diagnosis?
A. Rheumatism
B. Scleroderma
C. Dermatomyositis
D. Polyarteritis nodosa
E. Systemic lupus erythematosus
3. After a case of sepsis a 27-year-old
woman developed ”bronzed” skin di-
scoloration characteristic of Addison’s di-
sease. Hyperpigmentation mechanism in
this case is based on increased secretion of:
A. Melanocyte-stimulating hormone
B. Somatotropin
C. Gonadotropin
D. β -lipotropin
E. Thyroid-stimulating hormone
4. A 16-year-old girl presents with no hair on
the pubis and in the armpits, her mammary
glands are underdeveloped, no menstruati-
ons. What hormone imbalance can it be
indicative of?
A. Ovarian failure
B. Hyperthyroidism
C. Hypothyroidism
D. Pancreatic islet failure
E. Adrenal medulla hyperfunction
5. From the feces of a patient with
acute gastroenteritis a pure culture of
microorganisms was obtained. The mi-
croorganisms are small mobile slightly
curved gram-negative bacilli that within 6
hours grow into a light blue film on the 1%
alkaline peptone water. Such properties are
characteristic of the following microorgani-
sm:
A. Vibrio
B. Spirochaete
C. Clostridium
D. Bacillus
E. Spirilla
6. A patient was brought into the infecti-
1
onal diseases hospital on the 8th day since
the disease onset. The patient complains of
headache, malaise, and weakness. A sample
of blood was taken for the serological test.
Widal agglutination test results with blood
sample diluted 1:200 and typhoid fever O-
diagnosticum were positive. What diagnosis
can be made based on the results of this
test?
A. Typhoid fever
B. Dysentery
C. Cholera
D. Leptospirosis
E. Tuberculosis
7. Protective function of saliva is based
on several mechanisms, including the
presence of enzyme that has bacterici-
dal action and causes lysis of complex
capsular polysaccharides of staphylococci
and streptococci. Name this enzyme:
A. Lysozyme
B. α-amylase
C. Oligo-1,6-glucosidase
D. Collagenase
E. β -glucuronidase
8. In the process of hemoglobin catabolism
iron is released and then as a part of speci-
al transport protein is returned to the bone
marrow, to be used again for hemoglobin
synthesis. Name this transport protein:
A. Transferrin
B. Transcobalamin
C. Haptoglobin
D. Ceruloplasmin
E. Albumin
9. The first-aid center has received a vi-
ctim of a traffic accident diagnosed with
closed displaced fracture of the middle thi-
rd of the thigh. For repositioning of bone
fragments the patient received 10 ml of
2% dithylinum solution intravenously, whi-
ch resulted in prolonged period of apnoea
and muscle relaxation. What enzyme is defi-
cient, resulting in such pharmacogenetic
enzymopathy?
A. Pseudocholinesterase
B. Uridine diphosphate
glucuronyltransferase
C. Glucose 6-phosphate dehydrogenase
D. Methemoglobin reductase
E. N-acetyltransferase
10. An 18-year-old student presents wi-
th enlarged thyroid gland accompanied by
accelerated metabolism and increased heart
rate. These signs can be observed during
hypersecretion of thyroxin. What organelles
of thyroid cells are primarily responsible for
hormone production and secretion?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
A. Golgi apparatus
B. Mitochondria
C. Ribosomes
D. Centrosomes
E. Lysosomes
11. A patient complains of pain in the upper
umbilical region. On palpation there is a
mobile painful intestine. What intestine is
being palpated by the doctor?
A. Transverse colon
B. Jejunum
C. Duodenum
D. Ileum
E. Sigmoid colon
12. A laboratory experiment on a dog
was used to study central parts of audi-
tory system. One of the mesencephalon
structures was destroyed. The dog has lost
the orienting response to auditory signals.
What structure was destroyed?
A. Inferior colliculi of corpora quadrigemina
B. Superior colliculi of corpora quadrigemi-
na
C. Substantia nigra
D. Reticular formation nuclei
E. Red nucleus
13. Histological investigation of the uterine
scrape of the 45-year-old woman with di-
sturbed ovarian menstrual cycle revealed
increased number of endometrial glands,
some of which are serrated, while others are
dilated and cyst-like. Make the diagnosis:
A. Endometrial cystic glandular hyperplasia
B. Placental polyp
C. Atypical endometrial hyperplasia
D. Glandular endometrial polyp
E. Endometrial adenocarcinoma
14. A 45-year-old man diagnosed with
hepatic cirrhosis and ascites underwent
drainage of 5 liters of fluid from his abdomi-
nal cavity, which resulted in development
of syncopal state due to insufficient blood
supply to the brain. What circulatory di-
sorder occurred in the abdominal cavity in
this case?
A. Arterial hyperemia
B. Ischemia
C. Venous hyperemia
D. Thrombosis
E. Embolism
15. During cholecystectomy besides a.
cystyca another artery was pulled into the
ligature. Ligation of this artery resulted in
right-sided necrosis of the liver which led to
the death of the patient. What artery was
mistakenly ligated along with a. cystyca?
2
A. Ramus dexter a. hepatica propria
B. А. hepatica communis
C. А. gasro-duodenalis
D. Ramus sinister a. hepatica propria
E. А. pancreato-duodenalis sup
16. Microscopy of the puncture sample
obtained from the inflammation focus of
the patient with cutaneous abscess revealed
numerous blood cells of different types.
What cells are the first to transfer from
vessels to tissues during inflammation?
A. Neutrophils
B. Monocytes
C. Basocytes
D. Eosinophils
E. Lymphocytes
17. During the first year of life an infant
presents with disturbed process of breast
milk curdling. What cells of the proper
gastric glands are functionally disturbed?
A. Main exocrinocytes
B. Parietal exocrinocytes
C. Cervical mucous cells
D. Accessory mucous cells
E. Exocrinocytes
18. A lab rat has subcutaneously received
mercury(II) chloride in the amount of 5
mg/kg. 24 hours later the plasma creatini-
ne concentration increased several times.
What mechanism of retention azotemia is
observed in this case?
A. Decreased glomerular filtration
B. Increased creatinine production in the
muscles
C. Increased creatinine reabsorption
D. Increased glomerular filtration
E. Increased creatinine production in the
renal tubules
19. Collagenosis patients typically present
with connective tissue destruction
processes. The presence of these processes
can be confirmed by the increase in:
A. Blood oxyproline and oxylysine
B. Blood creatine and creatinine
C. LDH-isoenzyme activity in the blood
D. Transaminase activity in the blood
E. Blood urates
20. A 63-year-old man suffers from
esophageal carcinoma, presents with
metastases into the mediastinal lymph
nodes and cancerous cachexia. What
pathogenetic stage of neoplastic process is
observed in the patient?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
A. Progression
B. Promotion
C. Transformation
D. Initiation
E. -
21. After an X-ray examination of the
tuberculosis clinic patient, he was diagnosed
with tumor of the right lung. During operati-
on the surgeon removed the middle lobe of
the patient’s right lung. This lobe includes:
A. Segmentum laterale et segmentum mediale
B. Segmentum basale anterius et posterius
C. Segmentum anterius et segmentum apicale
D. Segmentum lingualare superius et inferius
E. Segmentum apicale (superius) et
segmentum basale mediale
22. A 2-year-old child presents with physical
retardation and frequent pneumonias. The
child was diagnosed with non-closure of the
arterial canal. Hemodynamics disturbance
in this case is caused by communication
between the:
A. Aorta and pulmonary trunk
B. Pulmonary trunk and pulmonary veins
C. Superior vena cava and aorta
D. Superior vena cava and pulmonary trunk
E. Aorta and pulmonary veins
23. A child diagnosed with purulent
inflammation of the middle ear was brought
to the otolaryngology department. The di-
sease started with the inflammation of the
nasopharynx. It was determined that the
infection had reached the tympanic cavity
through the eustachian tube that is located
in the:
A. Canalis musculotubarius
B. Сanaliculus tympanicus
C. Сanalis caroticus
D. Сanaliculus chordae tympani
E. Сanaliculi caroticо tympanici
24. During the prestart period an athlete
develops increased frequency and force
of cardiac contractions. These changes are
caused by intensification of the following
reflex responces:
A. Sympathetic conditioned
B. Sympathetic unconditioned
C. Parasympathetic conditioned
D. Parasympathetic unconditioned
E. Peripheral
25. Due to trauma the patient has lost
25% of circulating blood volume. Name the
emergency compensatory mechanism agai-
nst blood loss:
3
A. Interstitial fluid inflow to the vessels
B. Restoration of blood protein composition
C. Increase of reticulocyte number
D. Restoration of erythrocyte number
E. Erythropoiesis activation
26. ECG analysis of the patient shows that
the T waves are positive in the second
standard limb lead and their amplitude
and duration is normal. The conclusion can
be made that the following process occurs
normally in the patient’s ventricles:
A. Repolarization
B. Depolarization
C. Excitation
D. Contraction
E. Relaxation
27. A patient demonstrates sharp decrease
of pulmonary surfactant activity. This condi-
tion can result in:
A. Alveolar tendency to recede
B. Decreased airways resistance
C. Decreased work of expiratory muscles
D. Increased pulmonary ventilation
E. Hyperoxemia
28. After a case of common cold the patient
developed numbness of the right side of the
face. Examination revealed disturbed pain
and thermal sensitivity in the right half of
the face. What nerve was damaged?
A. Trigeminal
B. Facial
C. Glossopharyngeal
D. Vagus
E. Hypoglossal
29. X-ray exmination of a 57-year-old man
indicates local areas of hard bone tissue
resorption in some of the patient’s bones.
These changes can be associated with
increased activity of:
A. Osteoclasts
B. Chondroblasts
C. Osteocytes
D. Osteoblasts
E. Chondrocytes
30. A patient presents with acute attack of
cholelithiasis. Laboratory examination of
the patient’s feces will show the following in
this case:
A. Negative reaction to stercobilin
B. Positive reaction to stercobilin
C. Connective tissue
D. Partially digested cellulose
E. Starch granules
31. During autopsy of a 34-year-old man,
who died of chronic kidney failure due
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
to renal amyloidosis, in the lungs (mai-
nly in the lower lobes) the pathologist
detected multiple bronchial dilations filled
with purulent masses accumulated in the
bronchial lumen. Surface of the lungs secti-
on has fine-meshed pattern and resembles a
honeycomb. Histologically there is a chronic
inflammation detected in the bronchial wall,
muscle fibers are replaced with connective
tissue. These changes in the lungs can be
defined as:
A. Bronchiectases
B. Bronchopneumonia
C. Chronic bronchitis
D. Chronic pneumonia
E. Lung abscesses
32. Initial inoculation of water in 1%
peptone water resulted in growth of a thin
film on the medium surface in 6 hours.
Such cultural properties are characteristic
of causative agent of the following disease:
A. Cholera
B. Plague
C. Tuberculosis
D. Dysentery
E. Pseudotuberculosis
33. A 30-year-old man complains of
suffocation, heaviness in the chest on the
right, general weakness. Body temperature
is 38.9o C . Objectively the right side of
the chest lags behind the left side during
respiration. Pleurocentesis yielded exudate.
What is the leading factor of exudation in
the patient?
A. Increased permeability of the vessel wall
B. Increased blood pressure
C. Hypoproteinemia
D. Erythrocyte aggregation
E. Decreased resorption of pleural fluid
34. A 42-year-old man with gout presents
with high content of uric acid in blood. The
patient was prescribed allopurinol to lower
the concentration of uric acid. Allopurinol
is a competitive inhibitor of the following
enzyme:
A. Xanthine oxidase
B. Adenosine deaminase
C. Adenine phosphoribosyltransferase
D. Hypoxanthine phosphoribosyltransferase
E. Guanine deaminase
35. Autopsy revealed a large wedge-shaped
patch of a dense dark red tissue with clear
margins in the upper lobe of the right lung.
Histological examination detected there
necrosis of the alveolar walls; the alveolar
lumen is tightly packed with erythrocytes.
What process occurred in the lungs?
4
A. Hemorrhagic infarction
B. Carneous degeneration
C. Gangrene
D. Hemorrhage
E. Atelectasis
36. A patient complains of dizziness, thirst,
difficult swallowing, and impaired vision of
close objects. Objectively: respiratory rate
is increased, pupils are dilated, general agi-
tation, talkativeness, though the speech is
indistinct. BP is 110/70 mm Hg, heart rate
is 110/min. Given symptoms can indicate
overdosage of the following drug:
A. Atropine
B. Morphine
C. Ephedrine
D. Aminazine
E. Caffeine
37. A patient presents with indigestion,
stomachaches, and excessive salivation. Si-
milar simptoms had already been observed
in this patient previously. Laboratory
analysis detected oval eggs covered with
lumpy capsules in the patient’s feces. What
is the most likely cause of the patient’s di-
sorder?
A. Ascariasis
B. Trichocephaliasis
C. Diphyllobothriasis
D. Enterobiasis
E. Fascioliasis
38. Regional lymph nodes surrounding an
infected wound are enlarged. Histological
examination shows increased number of
macrophages, lymphocytes, and lymphatic
follicles, as well as a large amount of plasma
cells, in the cortical layer of the lymph
nodes. What process in the lymph nodes
is indicated by these histologic changes?
A. Antigen stimulation
B. Acquired deficiency of lymphoid tissue
C. Congenital deficiency of lymphoid tissue
D. Neoplastic aberration
E. Transplant rejection
39. During removal of the hyperplastic
thyroid gland of a 47-year-old woman,
the parathyroid gland was damaged.
One month after the surgery the pati-
ent developed signs of hypoparathyroi-
dism: frequent convulsions, hyperreflexia,
laryngospasm. What is the most likely cause
of the patient’s condition?
A. Hypocalcemia
B. Hyponatremia
C. Hyperchlorhydria
D. Hypophosphatemia
E. Hyperkalemia
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
40. On examination the patient presents
with hirsutism, moon-shaped face, stretch
marks on the abdomen. BP is 190/100
mm Hg, blood glucose is 17.6 mmol/L.
What pathology is such clinical presentation
characteristic of?
A. Adrenocortical hyperfunction
B. Hyperthyroidism
C. Hypothyroidism
D. Gonadal hypofunction
E. Hyperfunction of the insular apparatus
41. A 45-year-old woman presents with
breast cancer. Metastases can spread in this
case to the following regional lymph nodes:
A. Axillary, parasternal
B. Abdominal, cervical
C. Cervical, parasternal
D. Parasternal, mediastinal
E. Aortic, mediastinal
42. A 40-year-old pregnant woman
underwent amniocentesis. Examination
determined the fetal karyotype to be 47,
XY+21. What fetal pathology was detected?
A. Down syndrome
B. Klinefelter syndrome
C. Turner syndrome
D. Phenylketonuria
E. Patau syndrome
43. A patient used an indirect-acting
adrenergic agonist to treat rhinitis. After the
patient has been putting in the nose drops
for several days, the vasoconstrictive effect
of the drug gradually diminished. Name this
phenomenon:
A. Tachyphylaxis
B. Idiosyncrasy
C. Teratogenicity
D. Allergy
E. Cumulation
44. In a township there was registered an
outbreak of hepatitis, which had supposedly
spread through the water supply. What
hepatitis virus could be the cause of the
outbreak in this township?
A. Hepatitis E virus
B. Hepatitis C virus
C. Hepatitis D virus
D. Hepatitis G virus
E. Hepatitis B virus
45. A medical student was hospitalized
into the infectious diseases unit on the 2nd
day after the disease onset; the patient is
suspected to have infectious mononucleosis.
What results of laboratory analysis can
confirm this diagnosis immediately on the
day of the hospitalization?
5
A. IgM antibodies to Epstein-Barr virus
were detected
B. IgM antibodies to herpes simplex virus
were detected
C. Fourfold increase in number of antibodies
to Epstein-Barr virus was detected
D. Herpesvirus was isolated
E. Cytomegalovirus antibodies were
detected
46. A 64-year-old woman presents with di-
sturbed fine motor function of her fingers,
marked muscle rigidity, and tremor. The
neurologist diagnosed her with Parkinson’s
disease. What brain structures are damaged
resulting in this disease?
A. Substantia nigra
B. Thalamus
C. Red nuclei
D. Cerebellum
E. Reticular formation
47. A 20-year-old young man with tall
stature, asthenic body type, signs of
hypogonadism and gynecomastia, and low
sperm count (azoospermia) has karyotype
47, XXY. What hereditary syndrome can
be characterized by this chromosomal
anomaly?
A. Klinefelter syndrome
B. Wiskott-Aldrich syndrome
C. Turner syndrome
D. Louis-Bar syndrome (ataxia-
telangiectasia)
E. Down syndrome
48. Pathogenic staphylococcus was obtained
from the purulent wound of the patient. Its
antibiotic sensitivity was determined to be
as follows: penicillin growth inhibition zone
- 8 mm; oxacillin - 9 mm, ampicillin - 10
mm, gentamicin - 22 mm, lincomycin - 11
mm. What antibiotic should be chosen for
treatment in this case?
A. Gentamicin
B. Oxacillin
C. Ampicillin
D. Penicillin
E. Lincomycin
49. A patient presents with dilated blood
vessels of the anterior medial surface of the
lower leg. This condition resulted from the
dilation of the following blood vessel:
A. V. saphena magna
B. А. tibialis anterior
C. V. saphena parva
D. А. tibialis posterior
E. V. poplitea
50. A patient, who had received a thermal
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
burn, developed painful boils filled with
turbid liquid on the skin. What morphologi-
cal type of inflammation has developed in
the patient?
A. Serous
B. Proliferative
C. Croupous
D. Granulomatous
E. Diphtheritic
51. Nitrogen is being excreted from the
body mainly as urea. When activity of a
certain enzyme in the liver is low, it results
in inhibition of urea synthesis and nitrogen
accumulation in blood and tissues. Name
this enzyme:
A. Carbamoyl phosphate synthetase
B. Aspartate aminotransferase
C. Urease
D. Amylase
E. Pepsin
52. Coronary artery thrombosis resulted
in development of myocardial infarction.
What mechanisms of cell damage are leadi-
ng in this disease?
A. Calcium
B. Lipid
C. Acidotic
D. Electroosmotic
E. Protein
53. People, who for a long time remained in
hypodynamic state, develop intense pain in
the muscles after a physical exertion. What
is the most likely cause of this pain?
A. Accumulation of lactic acid in muscles
B. Intensive breakdown of muscle proteins
C. Accumulation of creatinine in muscles
D. Decreased content of lipids in muscles
E. Increased content of ADP in muscles
54. Histological specimen shows organ
parenchyma to consist of lymphoid tissue
that forms lymph nodules; the nodules
are located diffusely and have a central
artery. What anatomical structure has such
morphological characteristics?
A. Spleen
B. Tonsil
C. Lymph node
D. Thymus
E. Red bone marrow
55. A 25-year-old woman complains of vi-
sual impairment. Examination revealed di-
sturbed eye accommodation, the pupil is
dilated and unresponsive to light. What
muscles are functionally disturbed in this
case?
6
A. Iris sphincter muscle, ciliary muscle
B. Iris dilator muscle, ciliary muscle
C. Superior oblique muscle, ciliary muscle
D. Lateral rectus muscle, iris sphincter
muscle
E. Iris sphincter and iris dilator muscles
56. A patient with hypochromic anemia has
hair with split ends and suffers from hair
loss. The nails are brittle. Gustatory sensati-
ons are affected. What is the mechanism of
development of these symptoms?
A. Iron enzymes deficiency
B. Vitamin B12 deficiency
C. Low production of parathyroid hormone
D. Vitamin A deficiency
E. Low production of thyroid hormones
57. A patient suffers from hepatic cirrhosis.
What substance excreted in urine should
be analyzed to characterize the antitoxic
function of liver?
A. Hippuric acid
B. Ammonium salts
C. Creatinine
D. Uric acid
E. Amino acids
58. A 65-year-old woman, who had been
suffering from deep vein thrombophlebi-
tis of the lower leg, suddenly died when
awaiting her appointment with the doctor.
Autopsy revealed loose friable red masses
with corrugated dull surface in the main
pulmonary artery and its bifurcation. What
pathologic process was discovered by the
pathologist in the pulmonary artery?
A. Thromboembolism
B. Thrombosis
C. Tissue embolism
D. Foreign body embolism
E. Fat embolism
59. Blood of the patients with diabetes
mellitus shows increased content of free
fatty acids. Name the most likely cause of
this:
A. Increased activity of adipose triglyceride
lipase
B. Accumulation of palmitoyl-CoA in
cytosol
C. Activation of ketone bodies utilization
D. Activation of apoА1, apoА2, and apoА4
apolipoprotein synthesis
E. Decreased activity of plasma
phosphatidylcholine-cholesterol-
acyltransferase
60. Representatives of a certain human
population can be characterized by
elongated body, height variability, decreased
volume of muscle mass, increased length
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
of limbs, decreased size and volume of rib
cage, increased perspiration, decreased indi-
ces of base metabolism and fat synthesis.
What type of adaptive evolution is it?
A. Tropical
B. Arctic
C. Moderate
D. Intermediate
E. Mountain
61. A 56-year-old man complains of thirst
and frequent urination. The endocrinologist
diagnosed this patient with diabetes melli-
tus and prescribed him glibenclamide. What
mechanism of action does this drug have?
A. Stimulation of β -cells of islets of
Langerhans
B. Facilitates glucose uptake by the tissues
C. Facilitates glucose transport through cell
membranes
D. Suppression of α-cells of islets of
Langerhans
E. Inhibits glucose absorption in the intestine
62. Patients with bile duct obstruction typi-
cally present with inhibited blood clotting
and develop hemorrhages due to insuffici-
ent assimilation of vitamin:
A. K
B. A
C. D
D. E
E. C
63. A test animal receives electrical
impulses that irritate the sympathetic nerve
that innervates blood vessels of the skin.
What reaction will it cause in the blood
vessels?
A. Arterial and venous constriction
B. No reaction
C. Arterial dilation
D. Arterial and venous dilation
E. Venous dilation
64. Examination of the coronary arteries
revealed atherosclerotic plaques with calci-
nosis that narrow the arterial opening by
1/3. In the muscle there are numerous whi-
tish layers of connective tissue. Name the
process detected in the myocardium:
A. Diffuse cardiosclerosis
B. Tiger heart
C. Postinfarction cardiosclerosis
D. Myocarditis
E. Myocardial infarction
65. A person has increased pulmonary
ventilation due to physical exertion. What
indicator of external respiration will be si-
gnificantly increased compared to the resti-
7
ng state?
A. Respiratory volume
B. Vital lung capacity
C. Inspiratory reserve volume
D. Expiratory reserve volume
E. Total lung capacity
66. The carotid bodies on both sides were
removed in a test animal. Which of the li-
sted factors WILL NOT be able to cause
hyperventilation in the test animal?
A. Hypoxemia
B. Physical exertion
C. Hypercapnia
D. Acidosis
E. Increase of core body temperature
67. Due to prolonged stay in the mountai-
ns at the altitude of 3000 m above the sea
level, a person developed increased oxygen
capacity of blood, which was directly caused
by intensified production of:
A. Erythropoietins
B. Leukopoietins
C. Carbaminohemoglobin
D. Catecholamines
E. 2,3-bisphosphoglycerate
68. A woman has been limiting the amount
of products in her diet to lose some weight. 3
months later she developed edemas and her
diuresis increased. What dietary component
deficiency is the cause of this?
A. Proteins
B. Fats
C. Carbohydrates
D. Vitamins
E. Minerals
69. A microslide of the lung tissue sample
taken from a patient with pneumonia shows
damage to the cells that carry out respi-
ratory function. What cells of the alveolar
wall are damaged?
A. Type 2 alveolar cells
B. Type 1 alveolar cells
C. Macrophages
D. Club cells
E. Lymphocytes
70. After a psychic trauma a woman
developed periodical increases in her
blood pressure accompanied by headache,
palpitations, and general weakness. What
mechanism of hypertension development
does this woman have?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
A. Increased arteriolar tone
B. Increased circulating blood volume
C. Decreased cardiac output
D. Tachycardia
E. Venoconstriction
71. An electron micrograph of a nephron
segment shows cuboidal cells with cili-
ated lining on their apical surfaces; their
basal surfaces have basal striation with mi-
tochondria located between the cytolemma
invaginations. Name the described nephron
segment:
A. Proximal tubule
B. Collecting ducts
C. Distal tubule
D. Thin limbs of Henle’s loop
E. Glomerular capsule
72. A patient has been taking bisacodyl for
a long time to treat chronic constipation.
However, several weeks later the aperient
effect of the drug diminished. What is the
possible cause of this?
A. Acquired tolerance
B. Drug dependence
C. Material cumulation
D. Functional cumulation
E. Sensitization
73. A force generated by the muscle is not
enough to lift a load. What type of muscle
contraction occurs in this case?
A. Isometric
B. Tetanic
C. Isotonic
D. Eccentric
E. Concentric
74. Condition of a patient with diabetes
mellitus sharply deteriorated after a regular
injection of insulin. The patient became
anxious and broke out in cold sweat; tremor
of the extremities, general weakness, and
dizziness appeared. What medicine can
remove these symptoms?
A. Adrenaline
B. Tolbutamide
C. Caffeine
D. Noradrenaline
E. Glibutid (Buformin)
75. Microscopy of the myocardium of a girl,
who died of diphtheria due to heart failure,
shows fatty degeneration, multiple foci of
cardiomyocytes necrosis, and small foci of
cellular infiltrates in the interstitium. What
type of myocarditis is it?
8
A. Alterative
B. Diffuse exudative
C. Focal exudative
D. Interstitial
E. Granulomatous
76. A schizophrenia patient was prescribed
aminazine. What pharmacodynamic action
of this drug is the grounds for its prescripti-
on in this case?
A. Antipsychotic
B. Antiemetic
C. Hypothermic
D. Muscle relaxant
E. Hypotensive
77. A 40-year-old man developed skin
redness and swelling in the neck area,
where eventually a small abscess appeared.
On section the focus is dense and yellow-
green colored. In the purulent masses there
are white granules. Histologically there
are fungal druses, plasma and xanthome
cells, and macrophages detected. Specify
the most correct etiological name of this
pathological process:
A. Actinomycosis
B. Furuncle
C. Carbuncle
D. Syphilis
E. Leprosy
78. A patient was hospitalized into the
infectious diseases unit on the 11th day si-
nce the disease onset and provisionally di-
agnosed with typhoid fever. What biological
material should be collected from the pati-
ent for the analyzes at this stage?
A. Blood serum
B. Urine
C. Feces
D. Bile
E. Roseola secretion
79. A man with ischemic heart disease
has been taking his medicine too often
throughout a day, which resulted in poisoni-
ng. Examination detects cyanosis of skin
and mucosa, sharp drop of blood pressure,
tachycardia, and respiratory depression.
Blood methemoglobin is high. What type
of medicine did the patient overdose on?
A. Organic nitrates
B. α-adrenergic blockers
C. Calcium channel blockers
D. Adenosine-based drugs
E. Myotropic antispasmodics
80. General structure of eukaryotic genes is
as follows: exon-intron-exon. Such functi-
onal structure of a gene leads to certain
specifics of the transcription process. What
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
sequence will correspond with precursor
mRNA (immature)?
A. Exon-intron-exon
B. Exon-exon-intron
C. Exon-exon
D. Intron-exon
E. Exon-intron
81. Atria of a test animal were superdi-
stended with blood, which resulted in
decreased reabsorption of Na+ and water
in renal tubules. This can be explained by
the effect of the following factor on the ki-
dneys:
A. Natriuretic hormone
B. Aldosterone
C. Renin
D. Angiotensin
E. Vasopressin
82. A patient with clinical signs of a pri-
mary immunodeficiency has functionally di-
sturbed mechanism of antigen-presentation
to the immunocompetent cells. What cells
are likely to have structural defects?
A. Macrophages, monocytes
B. T-lymphocyte
C. B-lymphocyte
D. Fibroblasts
E. O-lymphocytes
83. During intensive muscle work there is a
large amount of ammonia produced in the
muscles. What amino acid plays the main
role in the transportation of ammonia to
the liver and participates in gluconeogenesis
reactions?
A. Alanine
B. Arginine
C. Lysine
D. Ornithine
E. Aspartate
84. Encephalopathy has developed in a chi-
ld with hemolytic disease of the newborn.
What substance had increased in the child’s
blood, resulting in damage to the CNS?
A. Unconjugated bilirubin
B. Bilirubin-albumin complex
C. Bilirubin glucuronide
D. Verdohemoglobin
E. Bile acids
85. Renal examination shows the kidney
to be swollen and plethoric, with easily
removable capsule. Renal pelvis and calyces
are dilated and filled with turbid urine; their
mucosa is dull and has hemorrhagic foci.
On section the renal tissue is variegated,
there are yellow-gray areas surrounded with
plethoric and hemorrhagic zone. What di-
9
sease can be characterized by such results
of macroscopic examination?
A. Acute pyelonephritis
B. Acute glomerulonephritis
C. Renal amyloidosis
D. Nephrolithiasis
E. Polycystic kidney
86. A 54-year-old man complains of general
weakness, frequent colds, and bruises
constantly appearing on his body. Blood
test: erythrocytes - 2.5 · 1012 /L; Hb- 80 g/L;
color index - 0.9; reticulocytes - absent;
platelets - 50 · 109 /L; leukocytes - 58 · 109 /L;
leukogram: basocytes - 5%, eosinophils -
15%, myeloblasts - 6%, myelocytes - 10%,
juvenile - 18%, stab neutrophils - 26%,
segmented neutrophils - 10%, lymphocytes
- 8%, monocytes - 2%, ESR - 40 mm/hour.
What hematologic conclusion can be made?
A. Chronic myelogenous leukemia
B. Leukemoid response
C. Myeloblastic leukemia
D. Chronic lymphocytic leukemia
E. Basophilic eosinophilic leukocytosis
87. A mutation has occurred in a cell in the
first exon of the structural gene. The number
of nucleotide pairs changed from 290 to 250.
Name this type of mutation:
A. Deletion
B. Inversion
C. Duplication
D. Translocation
E. Nullisomy
88. The dorsal root of the spinal nerve of a
test animal was severed. What changes will
occur in the innervation area?
A. Loss of sensitivity
B. Loss of motor function
C. Decreased muscle tone
D. Increased muscle tone
E. Loss of sensitivity and motor function
89. Due to destruction of certain structures
of the brainstem a test animal has lost its ori-
entation reflexes in response to strong light
stimuli. What structures were destroyed?
A. Anterior quadrigeminal bodies
B. Posterior quadrigeminal bodies
C. Red nuclei
D. Vestibular nuclei
E. Substantia nigra
90. A toxin neutralized with 0.4%
formaldehyde under 37-40o C for 4 weeks is
used for vaccination. This preparation was
first used by Gaston Ramon for diphtheria
prevention. Name this preparation:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
A. Anatoxin
B. Immunoglobulin
C. Antitoxic serum
D. Adjuvant
E. Inactivated vaccine
91. 24 hours after an appendectomy the
patient’s blood test shows neutrophilic
leukocytosis with a regenerative shift. What
is the most likely mechanism of absolute
leukocytosis development in the patient’s
peripheral blood?
A. Intensification of leukopoiesis
B. Leukocyte redistribution
C. Decreased leukocyte disintegration
D. Deceleration of leukocyte migration to
the tissues
E. Immunity activation
92. The right leg of a 40-year-old woman
measured at the shin level is by 2 cm smaller
in the diameter than the left leg. Ankle-
jerk (Achilles) and knee-jerk reflexes are
absent on the right. What is the most likely
mechanism of hyporeflexia development
during peripheral paralysis?
A. Disturbed conduction of stimulation
B. Inhibition of pyramidal motoneuron
C. Disturbed synaptic impulse transmission
D. Activation of excitatory impulses from
the CNS
E. Disturbed perception of stimulation
93. A 38-year-old man, who has
been suffering from systemic lupus
erythematosus for 3 years, developed di-
ffuse renal lesions accompanied by massi-
ve edemas, marked proteinuria, hyperli-
pidemia, and dysproteinemia. What is
the most likely mechanism of proteinuria
develoment in this case?
A. Autoimmune damage to the nephrons
B. Inflammatory damage to the nephrons
C. Ischemic damage to the tubules
D. Increased blood proteins
E. Morbid affection of the urinary tracts
94. A 59-year-old man, a business manager,
developed intense burning retrosternal pain
that irradiates to the left arm. The pain
occurred in the evening after the tax audit.
15 minutes later the patient’s condition
normalized. What mechanism of angina
pectoris development is leading in this pati-
ent?
A. Increased level of blood catecholamines
B. Coronary atherosclerosis
C. Intravascular aggregation of blood cells
D. Coronary artery thrombosis
E. Functional cardiac overload
95. A 25-year-old woman at her third
10
pregnancy with impending miscarriage was
brought to the hospital. What combination
of Rh-factor of the mother and the fetus can
be the cause of this condition?
A. Mother Rh (-), fetus Rh (+)
B. Mother Rh (-), fetus Rh (-)
C. Mother Rh (+), fetus Rh (-)
D. Mother Rh (+), fetus Rh (+)
E. -
96. A specimen of a 10-day-old human
embryo shows two interconnected sacs
(amniotic and yolk sacs). Name the
structure located in the place where these
two sacs connect:
A. Embryonic shield
B. Floor of the amniotic sac
C. Roof of the amniotic sac
D. Amniotic stalk
E. Extraembryonic mesoderm
97. A woman with the III (В), Rh (-) blood
group gave birth to a child with the II (А)
blood group. The child is diagnosed with
hemolytic disease of newborn caused by
rhesus incompatibility. What blood group
and Rh does the father have?
A. II (А), Rh (+)
B. I (0), Rh (+)
C. III (B), Rh (+)
D. I (0), Rh (-)
E. II (A), Rh (-)
98. A 40-year-old woman suffers from
Cushing’s disease - steroid diabetes.
On biochemical examination she has
hyperglycemia and hypochloremia. What
process activates in the first place in such
patients?
A. Gluconeogenesis
B. Glycogenolysis
C. Glucose reabsorption
D. Glucose transport to the cells
E. Glycolysis
99. A patient with a chemical burn has
developed esophageal stenosis. The pati-
ent presents with acute weight loss due
to problematic food intake. Blood test:
erythrocytes - 3.0 · 1012/L, Hb- 106 g/L, total
protein - 57 g/L. What type of starvation
does this patient suffer from?
A. Incomplete starvation
B. Protein starvation
C. Complete starvation
D. Water starvation
E. Absolute starvation
100. Autopsy of the body of a man, who
for a long time had been working at the
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк 11

factory with high content of silicon dioxide A. Benzylpenicillin

in the air, revealed enlarged dense lungs wi-
th numerous round and oval sclerotic foci.
The foci were miliary and larger in size and
colored gray or gray-black. What is the most
likely diagnosis?
A. Nodular silicosis
B. Diffuse sclerotic silicosis
C. Anthracosilicosis
D. Silicoanthracosis
E. Asbestosis
101. Autopsy of the body of a 50-year-
old man, who had been suffering from
tuberculosis and died of cardiopulmonary
decompensation, shows lobar affection of
the lungs: the upper lobe of the right lung is
enlarged, dense, yellow on section, crumbli-
ng, with pleural fibrin deposition. What type
of secondary tuberculosis can be characteri-
zed by this pathology?
A. Caseous pneumonia
B. Fibrous focal tuberculosis
C. Infiltrative tuberculosis
D. Tuberculoma
E. Acute focal tuberculosis
102. A woman has come to the hospital wi-
th complaints of general weakness, dizzi-
ness, and dyspnea. Resently she has been
taking levomycetin (chloramphenicol) for
prevention of enteric infection. Blood test:
erythrocytes - 1.9 · 1012 /L, hemoglobin - 58
g/L, color index - 0.9, leukocytes - 2.2 G/L,
reticulocytes - 0.3%. What type of anemia is
it indicative of?
A. Hypoplastic
B. Metaplastic
C. Aplastic
D. Hemolytic
E. Iron-deficiency
103. Preoperative examination revealed
prothrombin deficiency in the blood of the
patient. What drug should be preliminarily
prescribed to mitigate blood loss in the pati-
ent during the surgery?
A. Vicasol (Menadione)
B. Thrombin
C. Aminocapronic acid
D. Phenylin (Phenindione)
E. Contrykal (Aprotinin)
104. A patient with streptococcal infecti-
on of the gingiva was prescribed a drug
with β -lactam ring in its structure. What
drug of those listed below belongs to this
pharmacological group?
B. Rifampicin
C. Erythromycin
D. Streptomycin sulfate
E. Levomycetin (Chloramphenicol)
105. A microslide of the skin sample taken
from the finger of a child shows that epi-
dermis is insufficiently developed. What
germ layer was damaged in the process of
embryo development?
A. Ectoderm
B. Mesoderm
C. Endoderm
D. Mesenchyme
E. Ectomesenchyme
106. Neutralization of xenobiotics and acti-
ve endogenous metabolites often occurs via
introduction of an oxygen atom into the
substrate molecule. What process occurs as
the result?
A. Hydroxylation
B. Decarboxylation
C. Transamination
D. Phosphorilation
E. Deaminization
107. In the process of an experiment,
vascular resistance to the blood flow was
measured in the different areas of ci-
rculatory system. The highest resistance was
detected in the:
A. Arterioles
B. Arteries
C. Capillaries
D. Venules
E. Veins
108. A 34-year-old man died in a comatose
state. According to his family after a busi-
ness trip to an African country he developed
periodical jaundice attacks. Autopsy shows
the following: dense enlarged spleen with
slate-black pulp; enlarged plethoric liver,
gray-black on section; cerebral gray matter
is brown-gray; cerebral white matter contai-
ns numerous small hemorrhages. What
infectious disease can be suspected?
A. Malaria
B. Meningococcemia
C. Prion infection
D. Generalized herpetic infection
E. Generalized cryptococcosis
109. What diagnostic method should be
used in industry to test the raw leather for
presence of B. antracis?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк 12

A. Ascoli’s thermo precipitation test A. Acetylcholine

B. Microscopy with Burry-Gins stain B. Noradrenaline
C. Microscopy with Aujeszky stain C. Adrenaline
D. Bacteriological analysis D. Dopamine
E. Serological test E. Serotonin
110. A 46-year-old patient suffering from 115. A 17-year-old girl suffers from periodi-
ulcer disease of the stomach is diagnosed cal palpitations that last several minutes.
with rheumatoid arthritis. What antii- Her heart rate is 200/min., rhythmic. What
nflammatory drug would be the most advi- heart rhythm disorder developed in this
sable in this case? patient?
A. Celecoxib A. Paroxysmal tachycardia
B. Prednisolone B. Sinus tachycardia
C. Analgin (Metamizole) C. Sinus bradycardia
D. Promedol (Trimeperidine) D. Extrasystole
E. Paracetamol E. Atrioventricular block
111. A patient with myocardial infarction 116. Kidney X-ray image obtained by means
has acute heart failure. Among the drugs of pyelography shows that the minor calyces
that increase the force of heart contractions converge to form 2 major calyces that adjoin
the least dangerous in this case will be: to the renal pelvis, from which the ureter
exits. What type of urinary tract is it?
A. Dobutamine
B. Adrenaline A. Mature
C. Isadrinum (Isoprenaline) B. Embryonic
D. Euphyllin (Aminophylline) C. Bicornuate
E. Caffeine D. Cystic
E. Fetal
112. During intensive physical exertion,
one of the energy sources for the working 117. A patient has been brought into a
muscles is glucose produced as the result of surgical ward with an incised wound of the
gluconeogenesis. This process is the most anterior surface of the shoulder in its lower
intensive in the following organ: one-third. Flexing function was disturbed
in the shoulder and elbow joints, which is
A. Liver caused by the damage to the:
B. Brain
C. Lungs A. Biceps muscle of the arm
D. Muscles B. Triceps muscle of the arm
E. Stomach C. Anconeus muscle
D. Deltoid muscle
113. During inflienza epidemic, morbidity in E. Coracobrachial muscle
the schoolchildren, who did not participate
in sports, was 40%, while in the schoolchi- 118. A patient suffers from acute cardi-
ldren, who engaged in regular physical aci- opulmonary failure with pulmonary edema.
vities, morbidity did not exceed 20%. What What diuretic should be prescribed in the
adaptation mechanism ensured low morbi- given case?
dity in the physically active schoolchildren?
A. Furosemide
A. Cross-adaptation B. Triamterene
B. Specific adaptation C. Spironolactone
C. Physiological adaptation D. Hydrochlorothiazide (Dichlothiazidum)
D. Biochemical adaptation E. Acetazolamide (Diacarb)
E. Genetic adaptation
119. Ketosis develops in the patients with di-
114. Monoamine oxidase inhibitors are abetes mellitus, as the result of activation of
widely used as psychopharmacological fatty acids oxidation processes. What acid-
drugs. They change the level of nearly base imbalance can result from accumulati-
all neurotransmitters in synapses, with on of excessive ketone bodies in the blood?
the following neurotransmitter being the
exception: A. Metabolic acidosis
B. Metabolic alkalosis
C. No imbalance occurs
D. Respiratory acidosis
E. Respiratory alkalosis
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
120. A 5-year-old child is diagnosed
with Bruton syndrome (X-linked
agammaglobulinemia) that manifests itself
as severe clinical course of bacterial
infections and absence of B lymphocytes
and plasma cells. What changes of
immunoglobulin content can be observed in
blood serum of the child with immunodefi-
ciency?
A. Decreased IgA, IgM
B. Increased IgA, IgM
C. Decreased IgD, IgE
D. Increased IgD, IgE
E. No changes
121. During the skill-building session in mi-
crobiology the students need to stain the
prepared and fixed sputum smears obtained
form a tuberculosis patient. What staining
technique should be used in this case?
A. Ziehl-Neelsen
B. Burry
C. Giemsa
D. Gins
E. Gram
122. A woman with hypophyseal di-
abetes insipidus developed a water-mineral
imbalance. What type of water-mineral
imbalance develops in such cases?
A. Hyperosmolar dehydration
B. Hypoosmolar dehydration
C. Isoosmolar dehydration
D. Hypoosmolar hyperhydration
E. Hyperosmolar hyperhydration
123. First-year schoolchildren have received
tuberculin skin test (Mantoux test) at the
school nurse’s office. The purpose of this
test was:
A. To determine the children that need to
receive BCG vaccination
B. To preventively vaccinate against
tuberculosis
C. To measure immunity stress toward
diphtheria
D. To measure allergization rate toward
rickettsia
E. To detect parotitis in the schoolchildren
124. In an experiment it is necessary to
assess neuromotor and muscle excitability.
What value shoud be measured to make the
assessment?
A. Sensory threshold
B. Action potential amplitude
C. Resting potential
D. Threshold potential
E. Action potential duration
125. Vestibular receptors of semicircular
13
canals of a test animal have been destroyed.
What reflexes will disappear as a result?
A. Statokinetic reflex during movements
with angular acceleration
B. Statokinetic reflex during movements
with linear acceleration
C. Head-righting reflex
D. Body-righting reflex
E. Primary orienting reflex
126. Acute renal impairment caused death
of a patient with hemorrhage. Autopsy
revealed enlarged kidneys with broad pale
pink cortical layer expressively demarcated
from dark red renal pyramids. Macroscopic
examination revealed lack of epitheli-
al nuclei of the convoluted tubules,
tubulorrhexis, phlebostasis. The cell nuclei
of the choroid glomus and straight tubules
were present. What pathology is it?
A. Necronephrosis
B. Infarction
C. Glomerulonephritis
D. Pyelonephritis
E. Nephrosis
127. A boxer had sustained a blow to the
left parotid area, after which he developed
paralysis of the facial muscles on this side.
What nerve had been damaged?
A. Facial
B. Ophthalmic
C. Maxillary
D. Mandibular
E. Lesser petrosal
128. A patient has an open facial wound wi-
th undermined edges; tissue necrosis with
gradually developing partial gangrene that
nearly reaches the bone tissue is observed.
On close examination the wound contains
live larvae. The patient is diagnosed with
tissue myiasis. What Diptera larvae are the
causative agents of this disease?
A. Wohlfahrtia magnifica
B. Glossina palpalis
C. Musca domestica
D. Phlebotomus pappatachi
E. Stomoxys calcitrans
129. A hereditary disease - homocysti-
nuria - is caused by disturbed transformati-
on of homocysteine into methionine.
Accumulated homocysteine forms its di-
mer (homocystine) that can be found in uri-
ne. What vitamin preparation can decrease
homocysteine production?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
A. Vitamin B12
B. Vitamin C
C. Vitamin B1
D. Vitamin B2
E. Vitamin P P
130. During hypersensitivity skin test a pati-
ent received an allergen subcutaneously,
after which the patient developed skin
redness, edema, and pain due to histami-
ne action. This biogenic amine is produced
as the result of the following transformation
of histidine amino acid:
A. Decarboxylation
B. Methylation
C. Phosphorilation
D. Isomerization
E. Deaminization
131. During the fight a man has received a
strong blow to the upper anterior abdomi-
nal wall, which resulted in the cardiac arrest.
What mechanism has led to the cardiac
arrest in this case?
A. Parasympathetic unconditioned
B. Sympathetic unconditioned
C. Parasympathetic conditioned
D. Sympathetic conditioned
E. Peripheral
132. A woman has lost a lot of blood duri-
ng the childbirth. Her blood group needs to
be determined. Erythrocyte agglutination
occurred with standard serums 0 (I) and А
(II) and did not occur with standard serum
B (III). What blood group does this woman
have?
A. B (III)
B. 0 (I)
C. А (II)
D. АВ (IV)
E. -
133. A 60-year-old man diagnosed with
chronic heart failure was brought to the
hospital. After a long course of treatment
the patient developed signs of intoxicati-
on: dyspnea, extrasystole, nausea, and di-
sturbed perception of colors. What medici-
ne has caused such side-effects?
A. Digoxin
B. Anaprilin (Propranolol)
C. Nitroglycerine
D. Drotaverine
E. Furosemide
134. A patient with exacerbated peptic ulcer
disease of the stomach has made an appoi-
ntment with the doctor. What type of drugs
should be included in the complex therapy
of this patient?
14
A. H2 antagonists
B. H1 antagonists
C. α-adrenergic antagonists
D. β -adrenergic antagonists
E. α-adrenergic agonists
135. Autopsy of the body revealed waxy
degeneration of the rectus abdominis
muscles. In the terminal segment of the
small intestine there are ulcers 3-5 cm in
diameter. The ulcer walls are covered in
a crumbling grayish-white substance. The
ulcer edges are markedly raised above the
mucosa. Widal test is positive. Make the di-
agnosis:
A. Typhoid fever
B. Nonspecific ulcerative colitis
C. Relapsing fever
D. Crohn’s disease
E. Dysentery
136. Genealogical analysis of a child with
myotonic dystrophy determined that this di-
sease is present in every generation, equally
presented by the relatives of both genders,
the risk of inheriting this disease is equal no
matter which parent is affected. If one of the
parents is heterozygous for this disease and
the other parent is healthy, the risk of them
giving birth to a sick child is 50%. What type
of disease inheritance is it?
A. Autosomal dominant
B. Autosomal recessive
C. X-linked dominant
D. X-linked recessive
E. Y-linked
137. A 30-year-old man has undergone
surgical removal of a thyroid tumor. Hi-
stologically the tumor is made up of papi-
llary structures varying in size that emerge
from the inner surface of dilated cystic folli-
cles and are covered with atypical epitheli-
um. What is the most likely diagnosis?
A. Papillary carcinoma
B. Colloid nodular goiter
C. Macrofollicular adenoma
D. Follicular carcinoma
E. Medullary carcinoma
138. A young woman, a foreign student
from Tehran, has made an appointment with
the urologist. She complains of the sensati-
on of heaviness in her lower abdomen and
a small amount of blood being excreted
with urine at the end of each urination.
Microscopy of urine detects the presence
of parasite eggs, approximately 140х70 mi-
cron in size, with a terminal spike. What
diagnosis can be made by the infectious di-
seases specialist?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
A. Schistosomiasis
B. Opisthorchiasis
C. Dicroceliasis
D. Paragonimiasis
E. Fascioliasis
139. Various biological preparations can be
used for poliomyelitis prevention. What
drug induces the type of local intestinal
mucosal immunity that lasts the longest?
A. Oral vaccination with live vaccine
B. Parenteral vaccination with inactivated
vaccine
C. Oral introduction of poliovirus-specific
immunoglobulin
D. Parenteral vaccination with live vaccine
E. Parenteral introduction of normal human
immunoglobulin
140. Histological analysis of a removed skin
tumor shows clusters and bands composed
of atypical stratified squamous epithelium
cells that penetrate into the underlying ti-
ssue. What preliminary diagnosis can be
made?
A. Non-keratinizing squamous cell carci-
noma
B. Solid cancer
C. Carcinoma in situ
D. Papilloma
E. Adenoma
141. Autopsy of a patient, who died of bi-
lateral bronchopneumonia, shows in the left
lung lower lobe a cavity 5 cm in diameter,
filled with yellowish-white liquid. What
complication of the patient’s pneumonia
had developed?
A. Abscess
B. Gangrene
C. Granuloma
D. Sequestrum
E. Tuberculoma
142. A patient with parkinsonism was
prescribed levodopa, which led to rapid
improvement of the patient’s condition.
What is the mechanism of action of this
drug?
A. Stimulation of dopamine synthesis
B. Muscarinic acetylcholine receptor
blockade
C. Stimulation of dopamine receptors
D. Anticholinesterase action
E. Muscarinic acetylcholine receptor sti-
mulation
143. A sick child presents with high content
of phenyl pyruvate in urine (normally it
is practically absent). Blood phenylalanine
level is 350 mg/L (norm - 15 mg/L). What di-
sease are these symptoms characteristic of?
15
A. Phenylketonuria
B. Albinism
C. Tyrosinosis
D. Alkaptonuria
E. Gout
144. An oncology patient is to undergo a
surgery on the descending colon. Name the
main source of blood supply to this organ:
A. Inferior mesenteric artery
B. Superior mesenteric artery
C. Celiac trunk
D. Middle colic artery
E. Splenic artery
145. A patient presents with enlarged cervi-
cal lymph nodes. Other lymph nodes and
internal organs are without changes. Peri-
pheral blood test results are normal. Hi-
stological examination of biopsy material
taken from the cervical lymph node shows
smoothed-out pattern, absent follicles,
homogeneous cell composition represented
by lymphoblasts. The cells penetrate into
the lymph node capsule. What diagnosis can
be made?
A. Lymphoblastic leukemia
B. Myeloblastic leukemia
C. Erythroblastic leukemia
D. Sezary disease
E. Burkitt lymphoma
146. When studying the pulmonary venti-
lation values, the reduction of forced expi-
ratory volume has been detected. What is
the likely cause of this phenomenon?
A. Obstructive pulmonary disease
B. Increase of respiratory volume
C. Increase of inspiratory reserve volume
D. Increase of pulmonary residual volume
E. Increase of functional residual lung
capacity
147. A man is a carrier of HIV that is
an RNA virus. The cells of this patient
synthesize viral DNA. This process is based
on:
A. Reverse transcription
B. Replication
C. Transcription
D. Repair
E. Translation
148. Sanitary assessment of a pond, where
the children from a recreation summer
camp take their swims, detected there oval
cysts 50-60 micron in diameter, with 2 nuclei
visible in their cytoplasm (macronucleus
and micronucleus). What protozoa do these
cysts belong to?
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк 16

A. Balantidium
B. Lamblia A. Neurinoma
C. Toxoplasma B. Malignant neurinoma
D. Amoeba C. Ganglioneuroma
E. Euglena D. Neuroblastoma
E. Ganglioneuroblastoma
149. A hospital has received a 24-year-old
man, who had received a penetrating wound 154. A patient has undergone surgical
to the eye, which has caused the vitreous removal of the pylorus. Decreased secretion
body to run out. As the result of this, reti- of the following hormone can be expected:
nal detachment occurred. What retinal layer
was tightly adherent to the vascular tunic of A. Gastrin
the eye and did not detach? B. Histamine
C. Secretin
A. Retinal pigment epithelium D. Cholecystokinin
B. Layer of rods and cones E. Gastric inhibitory polypeptide
C. Ganglion cell layer
D. Outer nuclear layer 155. An electron micrograph shows a
E. Inner nuclear layer small vessel with endothelial layer but wi-
thout basement membrane and pericytes;
150. A newborn presents with weak suckli- anchoring fibrils are present. Name this
ng, frequent vomiting, and hypotonia. vessel:
Blood and urine citrulline are very high.
What metabolic process is disturbed? A. Lymph capillary
B. Arteriole
A. Ornithine cycle C. Venule
B. Tricarboxylic acid cycle D. Sinusoid hemocapillary
C. Glycolysis E. Visceral hemocapillary
D. Gluconeogenesis
E. Cori cycle 156. One of the causes of pernicious anemia
is disturbed synthesis of transcorrin -
151. Stool test detects in the patients feces a Castle’s intrinsic factor - by the parietal cells
large amount of undigested fats.This patient of the stomach. What substance is called
is the most likely to have disturbed secreti- Castle’s extrinsic factor?
on of the following enzymes:
A. Cobalamin
A. Pancreatic lipases B. Folic acid
B. Pancreatic amylase C. Pyridoxine
C. Pancreatic proteases D. Riboflavin
D. Bile lipase E. Biotin
E. Gastric protease
157. A patient with contact dermatitis needs
152. A 19-year-old young man was exami- to be prescribed an antihistamine drug wi-
ned in the nephrology clinic. High calcium thout somnolescent effect. Select this drug
was detected in his secondary urine. What from the list:
hormone is likely to cause such change, if it
is produced in excess? A. Loratadine
B. Dimedrol (Benadryl)
A. Aldosterone C. Suprastin (Chloropyramine)
B. Oxytocin D. Diprazine (Promethazine)
C. Adrenaline E. Ranitidine
D. Glucagon
E. Testosterone 158. Congenital pyruvate carboxylase defi-
ciency causes physical and mental retardati-
153. A young woman presents with a on in children and leads to early death. It
tumor along the auditory nerve. The tumor is characterized by lactic acidemia, lactaci-
is node-shaped, 3 cm in diameter, soft duria, and a number of metabolic disorders.
and elastic, pink-white colored, and has Among others, inhibition of the following
homogeneous structure. Microscopically occurs:
the tumor contains bundles of cells with
oval nuclei. These cellular fibrous bundles A. Citric acid cycle and gluconeogenesis
form regular structures made up of parallel B. Glycolysis and glycogenolysis
rows of regularly oriented cells arranged C. Glycogenesis and glycogenolysis
in the form of a palisade with acellular D. Lipolysis and lipogenesis
homogeneous area in between (Verocay E. Pentose-phosphate pathway and
bodies). Name this type of tumor: glycolysis
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк 17

159. A woman with enteritis accompani- substance is disturbed:

ed by severe diarrhea presents with loss of
water in the extracellular space, increased A. Sphingomyelinase
water content in the cells, and decreasing B. Glycosyltransferase
blood osmolarity. Name this type of water- C. Sphingosine
electrolyte imbalance: D. Ceramides
E. Gangliosides
A. Hypoosmolar hypohydration
B. Hyperosmolar hyperhydration 165. A traumatology unit has received a
C. Hyperosmolar hypohydration patient with a wrist trauma and a clinical
D. Hypoosmolar hyperhydration presentation of the damage to the nerve
E. Isoosmolar hypohydration that passes through the carpal tunnel. Name
this nerve:
160. To stimulate the labor activity a parturi-
ent woman was prescribed a drug - a A. N. medianus
posterior pituitary hormone that does not B. N. ulnaris
affect the blood pressure. As the pregnancy C. N. radialis
progresses, the sensitivity to this hormone D. N. axillaris
increases. Name the prescribed drug: E. N. musculocutaneus

A. Oxytocin 166. A patient, who has been taking β -

B. Dinoprostone
C. Dinoprost
D. Pituitrin
E. Ergotal
161. Cell membrane rest potential changed
from -85 to -90 mV. It can be caused by
activation of the following cell membrane
channels:
A. Potassium
B. Sodium
C. Potassium and sodium
D. Calcium
E. Potassium and calcium
162. Ionizing radiation or vitamin E defici-
ency affect the cell by increasing lysosome
membrane permeability. What are the possi-
ble consequences of this pathology?
A. Partial or complete cell destruction
B. Intensive protein synthesis
C. Intensive energy production
D. Restoration of cytoplasmic membrane
E. Formation of maturation spindle
163. A patient is diagnosed with
glucocerebroside lipidosis (Gaucher’s di-
sease) that manifests as splenomegaly, li-
ver enlargement, affected bone tissue, and
neuropathies. What enzyme of complex li-
pid catabolism is deficient, thus causing this
disease?
A. Glucocerebrosidase
B. Hexosaminidase
C. Sphingomyelinase
D. β -galactosidase
E. Hyaluronidase
164. A 3-year-old girl with mental retardati-
on has been diagnosed with sphingomyelin
lipidosis (Niemann-Pick disease). In this
condition the synthesis of the following
adrenergic blockers, developed a bronchi-
al spasm. What group of bronchodilators
should be chosen to stop the bronchial
spasm?
A. Myotropic antispasmodics
B. β -adrenergic blockers
C. Indirect adrenergic agonists
D. Muscarinic cholinomimetic agents
E. Cholinesterase inhibitors
167. A man has an inguinal hernia. The
hernial sac exits through the following
opening:
A. Anulus superficialis canalis inguinalis
B. Foramen suprapiriforme
C. Linea alba
D. Anulus profundus canalis inguinalis
E. Anulus femoralis
168. After a nephrectomy the patient
developed enteroparesis. What cholinergic
agent with anticholinesterase action should
be prescribed in this case?
A. Proserin
B. Carbacholine
C. Aceclidine
D. Pilocarpine
E. Acetylcholine
169. Parenchyma of an organ is composed of
pseudounipolar neurons localized under the
capsule of connective tissue. Central place
belongs to nerve fibers. Name this organ:
A. Spinal ganglion
B. Sympathetic ganglion
C. Intramural ganglion
D. Nerve trunk
E. Spinal cord
170. An obstetrician-gynecologist measures
pelvis size of a pregnant woman. A caliper
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк
was used to measure the distance between
the two iliac crests. What measurement of
large pelvis was made?
A. Distantia cristarum
B. Distantia throchanterica
C. Distantia spinarum
D. Conjugata vera
E. Conjugata anatomica
171. Genetic recombination is achieved via
several mechanisms. One such mechanism
is crossingover. It occurs at the following
stage of prophase in the first meiotic divisi-
on:
A. Pachynema
B. Leptonema
C. Zygonema
D. Diplonema
E. Diakinesis
172. ECG of the patient shows increased
duration of the QRS complex. What is the
most likely cause?
A. Increased period of ventricular excitation
B. Disturbed conduction in the atrioventri-
cular node
C. Increased atrial excitability
D. Increased atrial and ventricular excitabili-
ty
E. Increased period of atrial excitation
173. A 50-year-old inpatient during exami-
nation presents with glucosuria and blood
glucose of 3.0 mmol/L, which are the most
likely to be caused by:
A. Renal disorder
B. Diabetes insipidus
C. Myxedema
D. Essential hypertension
E. Pellagra
174. A 40-year-old woman was diagnosed
with glomerulonephritis based on her cli-
nical symptoms and the results of urine
analysis. Anamnesis states chronic tonsilli-
tis. What microorganisms are the most likely
cause for her kidney damage?
A. Streptococci
B. Staphylococci
C. Escherichia
D. Mycoplasma
E. Meningococci
175. A 7-year-old child presents with
marked signs of hemolytic anemia. Bi-
ochemical analysis of erythrocytes determi-
ned low concentration of NADPH and
reduced glutathione. What enzyme is defi-
cient in this case leading to the biochemical
changes and their clinical manifestations?
18
A. Glucose-6-phosphate dehydrogenase
B. Hexokinase
C. Fructokinase
D. Pyruvate kinase
E. Lactate dehydrogenase
176. When examining a biopsy materi-
al obtained from the thyroid gland, the
pathologist discovered lymphocyte infi-
ltration of the thyroid tissues and destructi-
on of the parenchymal elements. Diffuse
lymphocyte infiltration with lymphoid folli-
cles was detected in the stroma. What is the
most likely diagnosis?
A. Hashimoto’s thyroiditis (chronic
lymphocytic thyroiditis)
B. Papillary thyroid cancer
C. Undifferentiated thyroid carcinoma
D. Solid adenoma of the thyroid
E. Graves’ disease (toxic diffuse goiter)
177. An 8-year-old girl presents with signs of
disturbed twilight vision. This condition is
caused by the deficiency of vitamin:
A. A
B. E
C. D
D. K
E. F
178. A 25-year-old young man came to the
doctor complaining of general weakness,
rapid fatigability, irritability, reduced worki-
ng ability, and bleeding gums. What vitamin
is likely to be deficient in this case?
A. Ascorbic acid
B. Riboflavin
C. Thiamine
D. Retinol
E. Folic acid
179. A 52-year-old man presents with fever
and pain in the joints. Both of his fi-
rst metatarsophalangeal articulations are
deformed, swollen, and reddened. Blood
urea is high. The patient is diagnosed wi-
th gout. What is the main developmental
factor in the pathogenesis of this disease?
A. Hyperuricemy
B. Argininosuccinic aciduria
C. Hyperazotemia
D. Hyperaminoacidemia
E. Citrullinuria
180. A person with the fourth blood group
(genotype IAIB) has in erythrocytes both
antigen A controlled by allele IA and
antigen B controlled by allele IB. This
phenomenon is an example of the following
gene interaction:
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк 19

A. Codominance 186. During surgery performed in abdomi-

B. Complementarity
C. Semidominance
D. Polymery
E. Epistasis
181. Vascular endothelium is characterized
by high metabolic activity and synthesi-
zes vasoactive substances. Among these
substances there is a potent vasodilator
synthesized from L-arginine. Name this
vasodilator:
A. Nitrogen oxide
B. Histamine
C. Bradykinin
D. Acetylcholine
E. Adrenaline
182. A victim of a traffic accident was recei-
ved by the intensive care unit. The patient is
in a grave condition that can be characteri-
zed as a severe pathologic process that leads
to exhaustion of vital functions and puts the
patient into the marginal state between life
and death due to critical reduction of capi-
llary circulation in the affected organs. The
patient is in the state of:
A. Shock
B. Collapse
C. Coma
D. Agony
E. Preagony
183. A person becomes less receptive to
pain in physically or emotionally straining
situations due to activation of:
A. Antinociceptive system
B. Thyroid gland functions
C. Nociceptive system
D. Adrenal glands functions
E. Parasympathetic nervous system
184. A patient suffers from posttraumatic
hemorrhage that resulted in development
of hemorrhagic shock. What volume of ci-
rculating blood was lost by the patient?
A. 25-40%
B. 40-50%
C. 12-25%
D. 50-75%
E. 3-20%
185. A patient with pulmonary tuberculosis
is prescribed the most effective anti-
tuberculous antibiotic. Name this drug:
A. Rifampicin
B. Tetracycline
C. Streptocide
D. Furasolidone
E. Bactrim (Co-trimoxazole)
nal cavity a surgeon located the ligament of
liver stretching from the anterior abdominal
wall (navel) to the inferior surface of liver.
What ligament is it?
A. Round ligament of the liver
B. Falciform ligament of the liver
C. Coronary ligament of the liver
D. Venous ligament of the liver
E. Triangular ligament of the liver
187. A patient has disturbed blood supply
to the anterior papillary muscle of the left
ventricle. What cardiac artery supplies this
muscle with blood?
A. Ramus interventricularis anterior
B. Ramus interventricularis posterior
C. A. coronaria dextra
D. Ramus circumflexus
E. Ramus marginalis
188. Autopsy of the body of an elderly man
revealed yellow spots and streaks in the
aortic intima and white-yellow protruding
plaques in the area of aortic bifurcation.
Microscopy (with hematoxylin and eosin
staining) shows round cavities in the thi-
ckened aortic intima. The cavities color
orange when stained with sudan 3 and are
surrounded with overgrown connective ti-
ssue. What process developed in the aortic
intima?
A. Metabolic disorder of cholesterol and
cholesterol ethers
B. Local hyalinosis
C. Metabolic disorder of neutral fat
D. Systemic hyalinosis
E. Secondary amyloidosis
189. An 18-year-old patient has developed
candidiasis after the case of pneumonia
treated with β -lactam antibiotic. What anti-
mycotic agent should be prescribed?
A. Fluconazole
B. Streptomycin
C. Ampicillin
D. Phthalylsulfathiazole
E. Trimethoprim/sulfamethoxazole (Bi-
septol)
190. Preventive vaccination against poli-
omyelitis is made with inactivated
vaccine introduced parenterally. What
immunoglobulins create the postvaccinal
immunity in this case?
A. IgM, IgG
B. IgG, secretory IgA
C. IgM, secretory IgA
D. Serum IgА, IgM
E. IgЕ, IgM
 Krok 1 Medicine (англомовний варiант, iноземнi студенти) 2018 рiк 20

191. During pregnancy a woman has been
taking an antiepileptic drug - sodium
valproate. It resulted in her child developing
a vertebral column malformation - spina bi-
fida. Name the described effect of the drug:
A. Teratogenic effect
B. Immunosuppressive effect
C. Acquired tolerance
D. Dependence
E. Sensitizing effect
192. A patient was prescribed atropi-
ne sulfate to treat intestinal colic. What
concomitant disease can be a contraindi-
cation for this drug?
A. Glaucoma
B. Bronchial asthma
C. Sinus bradycardia
D. Hypotension
E. Vertigo
193. A patient has developed status epilepti-
cus. What medicine should be used in this
case to stop the seizures?
A. Diazepam
B. Cyclodol (Trihexyphenidyl)
C. Diprazine (Promethazine)
D. Sodium bromide
E. Valerian extract
194. A 48-year-old man is unconscious.
He has a history of several syncopal
episodes with convulsions. ECG shows
deformed QRS complexes unconnected wi-
th P waves, atrial contractions are approxi-
mately 70/min., ventricular contractions -
25-30/min. Name the type of arrhythmia in
this case:
A. Complete atrioventricular block
B. First-degree atrioventricular block
C. Second-degree atrioventricular block
D. Intraatrial block
E. Intraventricular block
195. In human organism significant blood
loss leads to decreased blood pressure,
tachycardia, and weakness. Eventually the
sensation of thirst appears. What hormone
participates in the development of this
sensation?
A. Angiotensin 2
B. Cortisol
C. Serotonin
D. Dopamine
E. Adrenalin
196. After a trauma the man has lost skin
sensitivity on the lateral surface of his
forearm. What nerve of the brachial plexus
provides sensitivity of the affected area?
A. N. musculocutaneus
B. N. medianus
C. N. ulnaris
D. N. axillaris
E. N. radialis
197. Autopsy of a 50-year-old woman,
who had been suffering from systemic
connective tissue disease, reveals small
dense kidneys with lumpy surface. Mi-
croscopy of the renal glomeruli detects
there foci of fibrinoid necrosis, hyali-
ne thrombi, hematoxylin bodies, and
so-called ”wire loop thickening” of the
basement membranes. What disease can
be characterized by such changes in the ki-
dneys?
A. Systemic lupus erythematosus
B. Rheumatism
C. Scleroderma
D. Rheumatoid arthritis
E. Dermatomyositis
198. A 4-year-old child presents with
numerous carious cavities and yellow-
colored teeth. The mother has a history of
antibiotic treatment during her pregnancy.
What antibiotic was the most likely taken
by the child’s mother?
A. Doxycycline
B. Streptomycin sulfate
C. Ampicillin
D. Erythromycin
E. Cefazolin
199. A patient developed pyoinflammatory
process of periodontal tissues caused by
activation of the microorganisms inherent
in the body, which are a part of oral mucosal
microflora. What type of infection is it?
A. Autoinfection
B. Exogenous infection
C. Reinfection
D. Superinfection
E. Relapse
200. After a hand fracture the man has lost
the ability to touch his little finger with the
thumb on the affected hand. Examination of
the palmar surface shows one of the palmar
muscles to be atrophied. Name the affected
muscle:
A. M. opponens policis
B. Mm. lumbricales
C. Mm. interossei
D. M. flexor digiti minimi
E. M. palmaris brevis
INSTRUCTIONAL BOOK
Testing Board

TEST ITEMS FOR LICENSING EXAMINATION: KROK 1. MEDICINE.

Kyiv. Testing Board.

(English language).

A ed i 03.05/ 249 Pa e i e 60 84 1/8

Offset paper. Typeface. Times New Roman Cyr. Offset print.
Conditional print pages 20. Accounting publishing pages 24.
Issue. 3285 copies.
List of abbreviations

A/G Albumin/globulin ratio HR Heart rate

A-ANON Alcoholics anonymous IDDM Insulin dependent diabetes mellitus
ACT Abdominal computed tomography IFA Immunofluorescence assay
ADP Adenosine diphosphate IHD Ischemic heart disease
ALT Alanin aminotranspherase IU International unit
AMP Adenosine monophosphate LDH Lactate dehydrogenase
AP Action potential MSEC Medical and sanitary expert committee
ARF Acute renal failure NAD Nicotine amide adenine dinucleotide
AST Aspartat aminotranspherase NADPH Nicotine amide adenine dinucleotide
ATP Adenosine triphosphate phosphate restored
BP Blood pressure NIDDM Non-Insulin dependent diabetes mellitus
bpm Beats per minute PAC Polyunsaturated aromatic carbohydrates
C.I. Color Index PAS Periodic acid & shiff reaction
CBC Complete blood count pCO2 CO2 partial pressure
CHF Chronic heart failure pO2 CO2 partial pressure
CT Computer tomography pm Per minute
DIC Disseminated intravascular coagualtion Ps Pulse rate
DCC Doctoral controlling committee r roentgen
DM-2 Non-Insulin dependent diabetes mellitus RBC Red blood count
DTP Anti diphtheria-tetanus vaccine RDHA Reverse direct hemagglutination assay
ECG Electrocardiogram Rh Rhesus
ESR Erythrocyte sedimentation rate (R)CFT Reiter's complement fixation test
FC Function class RIHA Reverse indirect hemagglutination assay
FAD Flavin adenine dinucleotide RNA Ribonucleic acid
FADH2 Flavin adenine dinucleotide restored RR Respiratory rate
FEGDS Fibro-esphago-gastro-duodenoscopy S1 Heart sound 1
FMNH2 Flavin mononucleotide restored S2 Heart sound 2
GIT Gastrointestinal tract TU Tuberculin unit
GMP Guanosine monophosphate U Unit
Hb Hemoglobin USI Ultrasound investigation
HbA1c Glycosylated hemoglobin V/f Vision field
Hct Hematocrit WBC White blood count
HIV Human immunodeficiency virus X-ray Roentgenogram
 Ashiq Tutorials

Krok-1 Question Paper

2019
 Бiологiя 2

1. A young man has come to A. Repair

the genetic consultation. He complains B. Replication
of abnormalities in his physical and C. Transcription
reproductive development. Microscopy of his D. Reverse transcription
oral mucosa cells shows one Barr body. What E. Translation
karyotype is the most likely in this young
man? 6. A man is a carrier of HIV that is an RNA
virus. The cells of this patient synthesize viral
A. 47, ХХY DNA. This process is based on:
B. 45, Х0
C. 47, XY, +21 A. Reverse transcription
D. 47, XY, +18 B. Replication
E. 47, ХYY C. Transcription
D. Repair
2. The mother’s karyotype has 45 E. Translation
chromosomes. It was determined that
translocation of chromosome 21 to 7. The parents with normal hearing have two
chromosome 14 had occurred. What disorder daughters and a son, who are congenitally
is likely to be observed in the child of this deaf. Their other 5 children are healthy. What
woman if the father’s karyotype is normal? is the pattern of deafness inheritance in this
case?
A. Down syndrome
B. Klinefelter syndrome A. Autosomal recessive
C. Patau syndrome B. Autosomal dominant
D. Edwards syndrome C. X-linked recessive
E. Morris syndrome (androgen insensitivity) D. X-linked dominant
E. Y-linked
3. During regular examination of
schoolchildren, a scrape from the perianal 8. Ingestion of plants and mushrooms that
folds of a 10-year-old girl shows asymmetrical grow along highways is dangerous due to risk
oval eggs with larvae inside. What diagnosis of lead poisoning. What is the main source of
can be made? environmental pollution with this chemical
element?
A. Enterobiasis
B. Ascariasis A. Exhaust fumes
C. Amebiasis B. Sewage
D. Trichuriasis C. Acid rains
E. Ancylostomiasis D. Herbicides
E. Chemical fertilizers
4. A young woman, a foreign student from
Tehran, has made an appointment with the 9. Long-term taking of medicines can
urologist. She complains of the sensation of affect cells of the liver. Particularly, it can
heaviness in her lower abdomen and a small cause marked hypertrophy of agranular
amount of blood being excreted with urine endoplasmic reticulum due to the following
at the end of each urination. Microscopy of function of this organelle:
urine detects the presence of parasite eggs, A. Detoxication of harmful substances
approximately 140х70 micron in size, with a B. Nucleic acid synthesis
terminal spike. What diagnosis can be made C. Protein synthesis
by the infectious diseases specialist? D. Formation of maturation spindle
A. Schistosomiasis E. Intracellular digestion
B. Opisthorchiasis 10. Dwellers of a village located in the taiga
C. Dicroceliasis make a living by harvesting berries. Lately
D. Paragonimiasis the occurrence of alveococcosis in the village
E. Fascioliasis population has increased. What is the source
5. Cells of a person working in the Chornobyl of invasion in this case?
Exclusion Zone have undergone a mutation A. Foxes
in DNA molecule. However, with time the B. Fish
damaged interval of DNA molecule restored C. Sick people
ist initial structure with a specific enzyme. In D. Birds
this case the following occurred: E. Rodents
 Нормальна анатомiя
1. A patient with severe poisoning was
brought into the intensive care unit. In the
course of complex treatment the subclavian
vein needs to be catheterized for medicine
administration. This vein is located in the
following topographic structure:
A. Spatium antesсalenum
B. Spatium interscalenum
C. Spatium retrosternocleidomastoideus
D. Spatium interaрoneuroticum suprasternale
E. Trigonum omotrapezoideum
2. A 52-year-old woman came to the
neurologist with complaints of loss of skin
sensitivity on the right half of her face in
the area of the lower eyelid, nasal arch, and
upper lip. What branch of what nerve is
damaged in this patient?
A. Maxillary branch of the trigeminal nerve
B. Greater petrosal nerve branching from the
facial nerve
C. Ophthalmic branch of the trigeminal nerve
D. Mandibular branch of the trigeminal nerve
E. Chorda tympani branching from the facial
nerve
3. A patient with periodontitis of the lower
molar came to the doctor. It was determined
that the inflammatory process spread to
the lymph nodes. What lymph nodes were
the first to be affected by the inflammatory
process?
A. Submandibular
B. Lateral cervical
C. Anterior cervical
D. Submental
E. Facial
4. After an X-ray examination of the
tuberculosis clinic patient, he was diagnosed
with tumor of the right lung. During
operation the surgeon removed the middle
lobe of the patient’s right lung. This lobe
includes:
A. Segmentum laterale et segmentum mediale
B. Segmentum basale anterius et posterius
C. Segmentum anterius et segmentum apicale
D. Segmentum lingualare superius et inferius
E. Segmentum apicale (superius) et segmentum
basale mediale
5. A 30-year-old man with an incised wound
on the plantar surface of the left foot was
brought to the traumatology department.
Lifting of the lateral side of the foot
is limited. What muscle is likely to be
functionally disturbed?
A. Peroneus longus muscle
B. Anterior tibial muscle
C. Flexor hallucis longus muscle
D. Triceps muscle of calf
E. Soleus muscle
3
6. An ovarian tumor was detected in a
woman. She is prescribed a surgery. What
ligament should be severed by the surgeon to
separate the patient’s ovary from the uterus?
A. Proper ovarian ligament
B. Broad ligament of the uterus
C. Lateral umbilical ligament
D. Suspensory ligament of the ovary
E. Round ligament of the uterus
7. A 45-year-old woman presents with breast
cancer. Metastases can spread in this case to
the following regional lymph nodes:
A. Axillary, parasternal
B. Abdominal, cervical
C. Cervical, parasternal
D. Parasternal, bronchomediastinal
E. Aortic, bronchomediastinal
8. A 35-year-old man with a hand injury
came to the traumatology department.
Examination revealed an incised wound on
the palmar surface of the left hand; middle
phalanges of digits II-IV cannot be flexed.
What muscles are damaged?
A. Flexor digitorum superficialis
B. Flexor digitorum profundus
C. Lumbrical muscles
D. Palmar interossei
E. Dorsal interossei
9. Clinical course of urolithiasis was
complicated by the passage of a renal
calculus. Where in the ureter is it most likely
to stop?
A. At the border between the abdominal and
pelvic segments
B. In the renal pelvis
C. In the middle of the abdominal segment
D. 2 cm above the entrance to the urinary
bladder
E. 5 cm above the pelvic segment
10. The surgeon noticed aggregated
lymphoid nodules (Peyer’s patches) on the
intestinal mucosa. What portion of the
intestine is it?
A. Ileum
B. Jejunum
C. Cecum
D. Duodenum
E. Rectum
11. An oncology patient is to undergo a
surgery on the descending colon. Name the
main source of blood supply to this organ:
A. Inferior mesenteric artery
B. Superior mesenteric artery
C. Celiac trunk
D. Middle colic artery
E. Splenic artery
 Нормальна анатомiя
12. A patient presents with an inner ear
inflammation. On examination the doctor
states that the 1st neurons of the auditory
analyzer are affected. Where are these
neurons located?
A. G. spirale
B. G. vestibulare
C. G. geniculi
D. G. trigeminale
E. G. ciliare
13. A victim has received a deep incised
stab wound to the upper posterior surface
of the shoulder. Extension of elbow, hand,
and digits is impaired; skin sensitivity of the
posterior surface of the shoulder and forearm
is lost. What nerve is damaged in this case?
4
A. N. radialis
B. N. ulnaris
C. N. cutaneus brachii medialis
D. N. medianus
E. N. musculocutaneus
14. During an invasive operation the surgeon
needs to access the omental bursa of the
peritoneal cavity via the omental foramen
(foramen of Winslow). What anatomical
structure makes up the anterior border of
this foramen?
A. Hepatoduodenal ligament
B. Hepatorenal ligament
C. Visceral surface of liver
D. Superior part of duodenum
E. Greater omentum
 Гiстологiя 5

1. Histone protein synthesis is artificially A. Tissue basophils

blocked in a cell. What cell structure will be B. Fibroblasts
damaged as a result? C. Plasma cells
D. Eosinophils
A. Nuclear chromatin E. Macrophages
B. Nucleolus
C. Golgi apparatus 5. A histological specimen demonstrates
D. Cell membrane a vessel with the wall that consists of
E. Nuclear membrane endothelium, basement membrane, and
loose connective tissue. This vessel belongs
2. Some diseases of large intestine lead to to the following type:
the changes in the quantitative ratio between
mucosal epithelial cells. What cell types A. Non-muscular vein
are normally predominant in the cryptal B. Artery
epithelium of the large intestine? C. Muscular vein
D. Hemocapillary
A. Goblet cells E. Lymph capillary
B. Ciliated columnar epithelial cells
C. Endocrine cells 6. Parenchyma of an organ is composed of
D. Cells with acidophilic granules pseudounipolar neurons localized under the
E. Poorly differentiated cells capsule of connective tissue. Central place
belongs to nerve fibers. Name this organ:
3. Examination of a surgically excised
adrenal gland shows large cells that can be A. Spinal ganglion
impregnated with a potassium dichromate B. Sympathetic ganglion
solution. What hormone is being synthesized C. Intramural ganglion
by these cells? D. Nerve trunk
E. Spinal cord
A. Adrenaline
B. Aldosterone 7. A histological specimen shows significant
C. Secretin amount of mucous connective tissue
D. Thyroxine (Wharton’s jelly), vessels, as well as remnants
E. Cholecystokinin of yolk sac stalk and allantois. Name this
organ:
4. An inflammation can be characterized by
hemocapillary dilation in the affected area, A. Umbilical cord
decreased blood circulation, and increased B. Esophagus
vessel wall permeability. What cells play the C. Ureter
key role in this process? D. Urethra
E. Vermiform appendix
 Нормальна фiзiологiя
1. A 40-year-old woman on examination
presents with intensified basal metabolic rate.
What hormone present in excess leads to
such condition?
A. Triiodothyronine
B. Thyrocalcitonin
C. Glucagon
D. Aldosterone
E. Somatostatin
2. Toxic damage to hepatic cells resulted in
disruption of the patient’s liver function and
the patient developed edemas. What changes
of blood plasma are the main cause of edema
development?
A. Decrease of albumin content
B. Increase of globulin content
C. Decrease of fibrinogen content
D. Increase of albumin content
E. Decrease of globulin content
3. An isolated heart was used to study
excitation conduction velocity in different
areas of the heart. What area had the lowest
velocity of excitation conduction?
A. Atrioventricular node
B. His bundle
C. Purkinje fibers
D. Atrial myocardium
E. Ventricular myocardium
4. A 40-year-old person developed
elevated blood pressure after an emotional
excitement. What is the likely cause of this
effect?
A. Increased sympathetic nervous system
tone
B. Arteriolar dilation
C. Decreased cardiac contraction frequency
D. Hyperpolarization of cardiomyocytes
E. Increased parasympathetic nervous system
tone
5. A patient has elevated blood pressure
due to increased vascular tone. To lower the
blood pressure in this case it is necessary to
prescribe the blockers of:
A. α-adrenoceptors
B. β -adrenoceptors
C. α- and β -adrenoceptors
D. Muscarinic acetylcholine receptors
E. Histamine H1 receptors
6. ABO blood group is being determined.
Erythrocyte agglutination occurred when
standard sera of group I and group II
were introduced into the blood being
analyzed, while group III serum caused no
agglutination. What agglutinogens do these
erythrocytes have?
6
A. B
B. A
C. A and B
D. C
E. D and C
7. What changes can be expected to occur
in the isolated heart of a toad, if excessive
amount of calcium chloride is introduced into
its perfusate?
A. Increased cardiac contraction force and
frequency
B. Decreased cardiac contraction force
C. Increased cardiac contraction frequency
D. Increased cardiac contraction force
E. Diastolic cardiac arrest
8. After hyperventilation an athlete
developed a brief respiratory arrest. It
occurred due to the following changes in the
blood:
A. Decrease of CO2 pressure
B. Decrease of pH
C. Increase of CO2 pressure
D. Decrease of O2 pressure
E. Increase of CO2 and O2 pressure
9. A person has increased pulmonary
ventilation due to physical exertion. What
indicator of external respiration will be
significantly increased compared to the
resting state?
A. Respiratory volume
B. Vital lung capacity
C. Inspiratory reserve volume
D. Expiratory reserve volume
E. Total lung capacity
10. A patient developed punctate
hemorrhages after a tourniquet had been
applied. It occurred due to functional
disturbance of the following blood
corpuscles:
A. Platelets
B. Eosinophils
C. Monocytes
D. Lymphocytes
E. Neutrophils
11. The dorsal root of the spinal nerve of a
test animal was severed. What changes will
occur in the innervation area?
A. Loss of sensitivity
B. Loss of motor function
C. Decreased muscle tone
D. Increased muscle tone
E. Loss of sensitivity and motor function
12. After a certain CNS structure had been
destroyed in a test animal, this animal lost its
orienting reflexes. What structure had been
destroyed?
 Нормальна фiзiологiя 7

A. Corpora quadrigemina peptides:

B. Red nuclei
C. Lateral vestibular nuclei A. Endorphins
D. Substantia nigra B. Liberins
E. Medial reticular nuclei C. Vasopressin
D. Oxytocin
13. On examination the patient was E. Statins
determined to have a strong, balanced, inert
type of higher nervous activity according to 19. I.M. Siechenov has proven that a tired
Pavlov’s classification. What temperament limb restores its working capacity faster if
according to Hippocrates is it? during its period of rest another limb works.
It became a basis for the concept of:
A. Phlegmatic
B. Sanguine A. Active rest
C. Choleric B. Parabiosis
D. Melancholic C. Pessimum
E. - D. Optimum
E. Fatigue
14. A 45-year-old woman presents with
insufficient secretion of enterokinase 20. Domestic accident has resulted in a
enzyme. Enterokinase deficiency can cause significant blood loss in the patient, which
disturbance of the following digestive was accompanied by a drop in blood
function: pressure. What hormones ensure quick
restoration of the blood pressure caused by a
A. Protein hydrolysis blood loss?
B. Carbohydrate hydrolysis
C. Lipid hydrolysis A. Adrenaline, vasopressin
D. Vitamin absorption B. Cortisol
E. Lipid absorption C. Reproductive hormones
D. Oxytocin
15. Systemic blood pressure of a person E. Aldosterone
equals 120/65 mm Hg. Blood ejection into
aorta occurs when left ventricular pressure 21. An experiment was conducted to
exceeds: measure the skin sensitivity threshold. What
patches of skin have the highest sensitivity
A. 65 mm Hg threshold?
B. 10 mm Hg
C. 90 mm Hg A. Back
D. 100 mm Hg B. Dorsal surface of the hand
E. 120 mm Hg C. Shoulder
D. Face
16. Prolonged vomiting resulted in E. Shin
dehydration of the patient’s body. Under
these conditons, water retention in the 22. A student, whose educational
body is ensured primarily due to increased achievements throughout the semester were
secretion of the following hormone: poor, feels emotionally tense during the final
test. What is the primary cause that induced
A. Vasopressin the leading mechanism of emotional tension
B. Aldosterone in this case?
C. Natriuretic hormone
D. Adrenaline A. Lack of information
E. Calcitonin B. Lack of time
C. Lack of time and energy
17. KCl concentration in a solution that D. Lack of energy
surrounds an isolated cell was increased. E. Lack of energy and information
How will resting membrane potential (RMP)
and cell excitability change in this case? 23. After a trauma the patient has developed
right-sided paralyses and disturbed pain
A. RMP decreases, excitability increases sensitivity. On the left side no paralyses are
B. RMP increases, excitability increases observed, but pain and thermal sensitivity
C. RMP increases, excitability decreases is disturbed. What is the cause of this
D. RMP decreases, excitability remains condition?
unchanged
E. RMP and excitability remain unchanged A. Unilateral right-side spinal cord injuiry
B. Midbrain injury
18. Human brain produces endogenous C. Brainstem injury
peptides that are similar to morphine and D. Cerebellar injury
can reduce pain perception. Name these E. Motor cortex injury
 Бiохiмiя
1. A 3-year-old child with elevated body
temperature has taken aspirin and developed
increased hemolysis of erythrocytes. In this
case hemolytic anemia can be caused by
congenital deficiency of the following enzyme:
A. Glucose 6-phosphate dehydrogenase
B. Glucose 6-phosphatase
C. Glycogen phosphorylase
D. Glycerol-phosphate dehydrogenase
E. Gamma-glutamyl transferase
2. Collagenosis patients typically present with
the processes of connective tissue destruction.
The presence of these processes can be
confirmed by the increase in:
A. Blood oxyproline and oxylysine
B. Blood creatine and creatinine
C. LDH-isoenzyme activity in the blood
D. Transaminase activity in the blood
E. Blood urates
3. During diabetes mellitus and starvation,
the number of acetone bodies in blood
increases. These bodies are used as a source of
energy and are synthesized from the following
substance:
A. Acetyl-CoA
B. Succinyl-CoA
C. Citrate
D. Malate
E. Ketoglutarate
4. Blood test of the patient revealed albumine
content of 20 g/L and increased activity of
lactate dehydrogenase isoenzyme 5 (LDH5 ).
These results indicate disorder of the
following organ:
A. Liver
B. Kidneys
C. Heart
D. Lungs
E. Spleen
5. A patient presents with an acute attack of
cholelithiasis. Laboratory examination of the
patient’s feces will show the following in this
case:
A. Negative reaction to stercobilin
B. Positive reaction to stercobilin
C. Connective tissue
D. Partially digested cellulose
E. Starch granules
6. A patient with diabetes mellitus after an
insulin injection lost his consciousness and
developed convulsions. What will be the result
of a biochemical test for blood glucose level
in this case?
A. 2.5 mmol/L
B. 3.3 mmol/L
C. 8.0 mmol/L
D. 10 mmol/L
E. 5.5 mmol/L
8
7. A 27-year-old patient presents with
pathologic changes in the liver and brain.
Blood plasma exhibits acute decrease in
copper levels, while urine copper levels
are elevated. The patient is diagnosed with
Wilson disease. To confirm this diagnosis it is
necessary to measure activity of the following
enzyme in the patient’s blood serum:
A. Ceruloplasmin
B. Carbonic anhydrase
C. Xanthine oxidase
D. Leucine aminopeptidase
E. Alcohol dehydrogenase
8. The Gerontology Institute recommends
older people to take vitamin complexes that
contain vitamin E. What is the main function
of this vitamin?
A. Antioxidant
B. Antihemorrhagic
C. Antiscorbutic
D. Antineuritic
E. Antidermatitic
9. Ammonia is extremely toxic for human
CNS. What is the main way of ammonia
neutralization in the nervous tissue?
A. Glutamine synthesis
B. Ammonium salts synthesis
C. Urea synthesis
D. Transamination
E. Formation of paired compounds
10. People, who for a long time remained in
hypodynamic state, develop intense pain in
the muscles after a physical exertion. What is
the most likely cause of this pain?
A. Accumulation of lactic acid in muscles
B. Intensive breakdown of muscle proteins
C. Accumulation of creatinine in muscles
D. Decreased content of lipids in muscles
E. Increased content of ADP in muscles
11. Human genetic apparatus consists of
approximately 30 thousand of genes, while the
number of antibody variants can be as high as
millions. What mechanism leads to formation
of new genes that ensure the synthesis of such
a number of antibodies?
A. Genetic recombination
B. Gene amplification
C. DNA replication
D. DNA repair
E. Formation of Okazaki fragments
12. Chronic overdose of glucocorticoids leads
to the development of hyperglycemia in a
patient. Name the process of carbohydrate
metabolism that results in elevated blood
glucose levels:
 Бiохiмiя 9

A. Gluconeogenesis activator, thromboxane A2. What substance is

B. Glycogenolysis this activator synthesized from?
C. Aerobic glycolysis
D. Pentose-phosphate pathway A. Arachidonic acid
E. Glycogenesis B. Malonic acid
C. Acetic acid
13. A patient for a long time was on an D. Homogentisic acid
imbalanced diet low in proteins, which E. Glutamic acid
resulted in hepatic fatty infiltration. This
condition is likely to develop if a certain 19. A patient with myocardial infarction in
substance is absent in a person’s diet. Name the acute phase has been hospitalized into
this substance: the cardiology unit. To induce platelet lysis in
the patient’s coronary vessels during the early
A. Methionine hours of infarction, the following enzyme
B. Alanine should be used:
C. Cholesterol
D. Acetic acid A. Streptokinase
E. Biotin B. Hyaluronidase
C. Trypsin
14. A patient, who has been subsisting D. Chymotrypsin
exclusively on polished rice, has developed E. Lysozyme
polyneuritis due to thiamine deficiency. What
substance is an indicator of such avitaminosis, 20. In the hematology unit a patient with
when it is excreted with urine? leukemia was prescribed 5-Fluorouracil. This
drug:
A. Pyruvic acid
B. Malate A. Inhibits DNA synthesis
C. Methylmalonic acid B. Stimulates DNase
D. Uric acid C. Inhibits translation
E. Phenyl pyruvate D. Inhibits transcription
E. Catalyzes replication
15. A 40-year-old man with pulmonary
tuberculosis was prescribed isoniazid. 21. A 7-year-old boy is diagnosed with anemia.
Prolonged taking of this drug can result Laboratory analysis detects pyruvate kinase
in development of the following vitamin deficiency in his erythrocytes. What process is
deficiency: disturbed in this boy, playing the main role in
anemia development in this case?
A. Pyridoxine
B. Thiamine A. Anaerobic glycolysis
C. Cobalamin B. Deaminization of amino acids
D. Biotin C. Decarboxylation of amino acids
E. Folic acid D. Gluconeogenesis
E. Anaerobic glycogenolysis
16. Disturbed activity of trypsin and
chymotrypsin leads to disturbed protein 22. Examination of a patient shows decreased
breakup in the small intestine. Activity of leukocyte and erythrocyte count and low
these enzymes depends on the presence of hemoglobin levels in peripheric blood, as well
the following factor: as appearance of large cells (megaloblasts).
What vitamin deficiency can cause these
A. Enterokinase clinical presentations?
B. Pepsin
C. Bile acids A. Folic acid
D. Hydrochloric acid B. Niacin
E. N a+ salts C. Ascorbic acid
D. Riboflavin
17. A newborn presents with weak suckling, E. Biotin
frequent vomiting, and hypotonia. Blood and
urine citrulline are very high. What metabolic 23. Wernicke-Korsakoff syndrome often
process is disturbed? develops in chronic alcoholics, who have a
low-vitamin diet. Decreased transketolase
A. Ornithine cycle activity can be observed in the course of this
B. Tricarboxylic acid cycle disease. What vitamin deficiency causes this
C. Glycolysis development?
D. Gluconeogenesis
E. Cori cycle A. Thiamine
B. Retinol
18. Patients with ischemic heart disease are C. Niacin
usually prescribed small doses of aspirin. This D. Cobalamin
drug inhibits synthesis of platelet aggregation E. Riboflavin
 Патологiчна фiзiологiя
1. A patient was hospitalized in a
comatose state. The patient has a 5-year-
long history of diabetes mellitus type 2.
Objectively respiration is noisy, deep, with
acetone breath odor. Blood glucose is 15.2
mmol/L, ketone bodies - 100 micromol/L.
These signs are characteristic of the following
diabetes complication:
A. Ketoacidotic coma
B. Hepatic coma
C. Hyperglycemic coma
D. Hypoglycemic coma
E. Hyperosmolar coma
2. A 63-year-old man suffers from esophageal
carcinoma, presents with metastases into
the mediastinal lymph nodes and cancerous
cachexia. What pathogenetic stage of
neoplastic process is observed in the patient?
A. Progression
B. Promotion
C. Transformation
D. Initiation
E. -
3. After a prolonged attack of severe
headache the patient lost mobility in his left
arm and leg. Muscle tone is decreased in
the affected limbs, the muscles are spasmed,
spinal tendon reflexes are acutely intensified,
reflex zones are increased. What nervous
system disorder can be observed in this
patient?
A. Central paralysis
B. Peripheral paralysis
C. Extrapyramidal paralysis
D. Flaccid paralysis
E. Reflex paralysis
4. Hematologic study shows the following
pattern: erythrocytes - 2, 8 · 1012 /L, Нb -
80 g/L, color index - 0.85, reticulocytes -
0,1%, platelets - 160 thousand per microliter,
leukocytes - 60 · 109 /L. Basocytes - 2%,
eosinophils - 8%, promyelocytes - 5%,
myelocytes - 5%, juvenile - 16%, stab
neutrophils - 20%, segmented neutrophils
- 34%, lymphocytes - 5%, monocytes -
5%. This clinical presentation indicates the
following blood pathology:
A. Chronic myeloleukemia
B. Acute myeloleukemia
C. Hypoplastic anemia
D. Undifferentiated leukemia
E. Hemolytic anemia
5. Antileukocytic antibodies are detected
in the blood of a patient with leukopenia.
What type of Coombs-Gell hypersensitivity
reaction developed in this case?
10
A. Cytotoxic
B. Stimulating
C. Anaphylactic
D. Delayed-type hypersensitivity
E. Immune complex-mediated
6. A patient with obliterating endarteritis
has undergone a ganglionic sympathectomy.
Positive therapeutic effect of this surgery
is associated with development of arterial
hyperemia of the lower limbs, which can be
described as:
A. Neuroparalytic
B. Neurotonic
C. Metabolic
D. Reactive
E. Working
7. In an experiment a laboratory rat was
subjected to a stress factor (electric current),
which resulted in muscular hypotonia,
arterial hypotension, hypothermia, and
hypoglycemia in the animal. What period of
general adaptation syndrome is it?
A. Shock phase
B. Antishock phase
C. Resistance stage
D. Exhaustion stage
E. -
8. A 14-year-old adolescent has diphtheria.
During the peak of the disease against
the background of acute drop in body
temperature and tachycardia the blood
pressure is 70/50 mm Hg. What type of
vascular tone disturbance is it?
A. Acute hypotension
B. -
C. Chronic hypotension
D. Somatoform autonomic dysfunction
E. Essential hypotension
9. 24 hours after an appendectomy the
patient’s blood test shows neutrophilic
leukocytosis with a regenerative shift. What
is the most likely mechanism of absolute
leukocytosis development in the patient’s
peripheral blood?
A. Intensification of leukopoiesis
B. Leukocyte redistribution
C. Decreased leukocyte disintegration
D. Deceleration of leukocyte migration to the
tissues
E. Immunity activation
10. A 59-year-old man, a business manager,
developed intense burning retrosternal pain
that irradiates to the left arm. The pain
occurred in the evening after the tax audit.
15 minutes later the patient’s condition
normalized. What mechanism of angina
pectoris development is leading in this
patient?
 Патологiчна фiзiологiя
A. Increased level of blood catecholamines
B. Coronary atherosclerosis
C. Intravascular aggregation of blood cells
D. Coronary artery thrombosis
E. Functional cardiac overload
11. A 30-year-old person has been stung
by a bee. The stung area exhibits edema,
hyperemia, and elevated temperature.
What is the initial pathogenetic factor of
inflammatory edema in this case?
A. Increase of microvascular permeability
B. Increase of osmotic pressure in the
inflammation focus
C. Decrease of oncotic blood pressure
D. Increase of capillary blood pressure
E. Disturbed lymphatic efflux
12. A 30-year-old woman developed
facial edemas. Examination detected
proteinuria (5.87 g/L), hypoproteinemia,
dysproteinemia, and hyperlipidemia. Such
combination of signs is characteristic of:
A. Nephrotic syndrome
B. Nephritic syndrome
C. Chronic pyelonephritis
D. Acute kidney failure
E. Chronic kidney failure
13. An uconscious young man in the state of
morphine intoxication has been brought into
an admission room. The patient’s respiration
is slow and shallow due to suppression of the
respiratory center. What kind of respiratory
failure occurred in this case?
A. Ventilatory disregulation
B. Ventilatory obstruction
C. Ventilatory restriction
D. Perfusion
E. Diffusion
14. A man has been working for a long time
in oil processing. What type of carcinogens
does he encounter at his workplace?
A. Polycyclic aromatic hydrocarbons
B. Amino-azo compounds
C. Nitrosamines
D. Biological carcinogens
E. Amines
15. A patient has been suffering from
bronchial asthma for 15 years. What changes
in the patient’s leukogram can be expected in
this case?
A. Eosinophilia
B. Basophilia
C. Leukocytosis
D. Leukopenia
E. Left shift
16. A married couple came for a genetic
counseling. The husband suffers from insulin-
independent diabetes mellitus, while the
11
wife is healthy. What is the probability of
their child developing insulin-independent
diabetes mellitus?
A. Higher than in the population
B. The same as in the population
C. Lower than in the population
D. 100%
E. 50%
17. A laboratory rat with chronic kidney
failure presents with osteoporosis, pathologic
calcification of the internal organs, and
arterial hypertension. These disturbances
are associated with increased activity of the
following hormone:
A. Parathyroid hormone
B. Thyroxin
C. Triiodothyronine
D. Calcitonin
E. Adrenaline
18. A patient is diagnosed with severe B12 -
deficiency anemia resulting in disturbed
hematopoiesis and appearance of atypical
erythrocytes in the blood. The patient has
a history of total gastric resection. This
diagnosis can be confirmed if the following
cells are present in the peripheral blood:
A. Megalocytes
B. Microcytes
C. Elliptocytes
D. Normocytes
E. Anulocytes
19. A patient with asphyxia after a
brief respiratory arrest developed single
infrequent respirations with passive
expiration, after which he stopped breathing
completely. What type of respiration was
observed in this case?
A. Gasping respiration
B. Apneustic respiration
C. Kussmaul respiration
D. Cheyne-Stokes respiration
E. Biot respiration
20. A 3-year-old child has been brought by
ambulance to the intensive care unit of the
infectious diseases hospital. On examination
the child is in severe condition, skin and
mucosa are dry, tissue turgor is reduced. The
patient’s history states that profuse diarrhea
and recurrent vomiting were observed
throughout the previous day after the child
had eaten food products of poor quality.
What type of salt and water imbalance is
likely to have developed in the patient?
A. Hypoosmolar dehydration
B. Isoosmolar dehydration
C. Hyperosmolar hyperhydration
D. Isoosmolar hyperhydration
E. Hypoosmolar hyperhydration
 Патологiчна фiзiологiя
21. A 48-year-old man is unconscious. He has
a history of several syncopal episodes with
convulsions. ECG shows deformed QRS
complexes unconnected with P waves, atrial
contractions are approximately 70/min.,
ventricular contractions - 25-30/min. Name
the type of arrhythmia in this case:
A. Complete atrioventricular block
B. First-degree atrioventricular block
C. Second-degree atrioventricular block
D. Intraatrial block
E. Intraventricular block
12
22. A 40-year-old man with impaired venous
patency in the lower limbs developed
edemas. What mechanism plays the main
role in the development of this disturbance?
A. Elevated filtration pressure
B. Positive fluid balance
C. Decreased gradient of osmotic pressure
between blood and tissue
D. Disturbed humoral regulation of water-
mineral balance
E. Hypoproteinemia
 Патологiчна анатомiя
1. Autopsy of a 60-year-old woman, who
for a long time had been suffering from
essential hypertension, shows significantly
diminished kidneys (weight of both kidneys
is 80 g) with finely granular surface. Uniform
renal cortical thinning can be observed on
section. Name the described changes in the
kidneys:
A. Primary contracted kidney
B. Pyelonephritic contracted kidney
C. Secondary contracted kidney
D. Amyloid contracted kidney
E. Diabetic nephrosclerosis
2. Autopsy of a 3-year-old child shows a
tumor in the cerebellum. The tumor has
no clear margins separating it from the
surrounding tissues. Histologically it is made
of small atypical cells with hyperchromic
nuclei. This tumor is most likely a:
A. Medulloblastoma
B. Medullary sarcoma
C. Cancer metastasis
D. Sarcoma metastasis
E. Glioblastoma
3. Autopsy revealed a large wedge-shaped
patch of a dense dark red tissue with clear
margins in the upper lobe of the right lung.
Histological examination detected there
necrosis of the alveolar walls; the alveolar
lumen is tightly packed with erythrocytes.
What process occurred in the lungs?
A. Hemorrhagic infarction
B. Carneous degeneration
C. Gangrene
D. Hemorrhage
E. Atelectasis
4. Regional lymph nodes surrounding an
infected wound are enlarged. Histological
examination shows increased number of
macrophages, lymphocytes, and lymphatic
follicles in the cortical layer of the lymph
nodes, as well as a large amount of plasma
cells. What process in the lymph nodes is
indicated by these histological changes?
A. Antigen stimulation
B. Acquired deficiency of lymphoid tissue
C. Congenital deficiency of lymphoid tissue
D. Neoplastic aberration
E. Transplant rejection
5. A patient has gradually developed a
skin plaque on his face. In the center of
this plaque there are necrotic patch and
an ulcer. Histopathological analysis of the
biopsy material reveals proliferation of
atypical epithelial cells with large number of
pathologic mitoses. What is the most likely
diagnosis?
13
A. Skin cancer
B. Sarcoma
C. Papilloma
D. Trophic ulcer
E. Fibroma
6. Histological analysis of a biopsy skin
sample obtained from a 24-year-old patient
detects caseous necrosis surrounded with
cellular infiltrate consisting of lymphocytes,
among which there are single giant cells;
proliferation of connective tissue and
endovasculites are observed. Characterize
this pathologic process:
A. Proliferative granulomatous inflammation
B. Proliferative interstitial inflammation
C. Abscess
D. Catarrhal inflammation
E. Ichorous inflammation
7. Autopsy of a man, who had been suffering
from mitral stenosis, reveals dense brown
lungs. What pathologic process had occurred
in the lungs?
A. Hemosiderosis
B. Hemochromatosis
C. Jaundice
D. Hemomelanosis
E. Lipofuscinosis
8. A 63-year-old man, who has been suffering
from chronic diffuse obstructive pulmonary
emphysema for 15 years, died of progressive
heart failure. Autopsy shows nutmeg liver
cirrhosis, cyanotic induration of kidneys and
spleen, ascites, and edemas of the lower
limbs. What type of heart failure can be
characterized by such changes in the internal
organs?
A. Chronic heart failure
B. Acute right ventricular failure
C. Chronic atrial failure
D. Acute left ventricular failure
E. Acute global heart failure
9. A 6-year-old girl presents with acute
onset of a disease. She developed sore
throat and high temperature that were
later accompanied by a punctate skin rash.
Oral examination reveals acute pharyngeal
hyperemia, raspberry tongue, and enlarged
bright red tonsils with dull gray and
yellow foci that spread to the peritonsillar
tissues. The submandibular lymph nodes are
enlarged. What disease are these changes
characteristic of?
A. Scarlet fever
B. Measles
C. Pharyngeal diphtheria
D. Laryngeal diphtheria
E. Meningococcal nasopharyngitis
10. Autopsy of a man, who served
on a nuclear submarine, revealed the
 Патологiчна анатомiя
following pathologies: bone marrow
atrophy (panmyelophthisis), anemia,
leukopenia, thrombocytopenia, lymphocytic
disintegration in the lymph nodes, spleen,
gastrointestinal lymphatic system, and
hemorrhages into the adrenal glands. What
disease had developed in this case?
A. Acute radiation sickness
B. Decompression sickness
C. Acute leukemia
D. Acute anemia
E. Vibration disease
11. A 9-month-old child presents with
delayed tooth eruption, improper sequence
of tooth eruption, and horizontal
maxillary configuration (high-arched palate).
Microscopically enamel mineralization
pattern is irregular, enamel columns are
wrinkled, some of them are vacuolated,
predentin zones are widened, single denticles
can be observed. What disease is it?
A. Early rickets
B. Late rickets
C. Osteomalacia
D. Gout
E. Hypervitaminosis D
12. Autopsy of a 58-year-old man, who for
a long time has been drinking alcohol in
large amounts and died at home, is being
conducted. Macroscopically the right lung
is dense and enlarged, its tissue is gray
and homogeneous on section, its pleura is
covered with grayish membranous deposits.
Microscopically the alveolar cavities contain
fibrin threads, neutrophils, and hemolysed
erythrocytes. Make the diagnosis:
A. Croupous pneumonia
B. Focal pneumonia
C. Interstitial pneumonia
D. Primary pulmonary tuberculosis
E. Caseous pneumonia
13. Autopsy of a 49-year-old woman who
died of chronic kidney failure shows
small dense striated kidneys with areas
of hemorrhages. Microscopically nuclei of
epithelial channels contain hematoxylin
bodies; glomerular capillaries resemble wire
loops, have thickened basement membranes,
and in places contain hyaline thrombi and
foci of fibrinoid necrosis. What is the most
likely diagnosis?
A. Systemic lupus erythematosus
B. Rheumatism
C. Arteriolosclerotic nephrosclerosis
D. Amyloidosis
E. Atherosclerotic nephrosclerosis
14. A 34-year-old man died in a comatose
state. According to his family after a business
14
trip to an African country he developed
periodical jaundice attacks. Autopsy shows
the following: dense enlarged spleen
with slate-black pulp; enlarged plethoric
liver, gray-black on section; cerebral gray
matter is brown-gray; cerebral white matter
contains numerous small hemorrhages. What
infectious disease can be suspected?
A. Malaria
B. Meningococcemia
C. Prion infection
D. Generalized herpetic infection
E. Generalized cryptococcosis
15. A 27-year-old woman has undergone a
sector resection of mammary gland tissue.
Macroscopy detects a dense white node, 4 cm
in diameter, with clear margins in the excised
tissue. Immediate histological analysis shows
the tumor to consist of a large amount of
fibrous stroma with stromal proliferation
around the small canaliculi. Canalicular
epithelium overlays the basement membrane
and retains its polarity. Make the diagnosis:
A. Pericanalicular fibroadenoma
B. Adenocarcinoma
C. Sarcoma
D. Dyshormonal disorders
E. Cancer
16. In the course of an urgent surgery, the
vermiform appendix of the patient was
excised. The appendix was acutely distended
and gray-black throughout its whole length.
In the distal segment a defect of the
appendix wall was detected, through which
a foul-smelling gray-brown substance was
being discharged from the appendix lumen.
Histological analysis shows necrotization of
the appendix wall with hemorrhagic foci;
lumen of the mesenteric artery is filled with
a trombus. What type of appendicitis is it?
A. Acute gangrenous
B. Acute phlegmonous
C. Acute simple
D. Acute superficial
E. Chronic
17. A 39-year-old man underwent a surgery
for peptic ulcer disease of the stomach. He
died 7 days after the surgery. On autopsy
the peritoneal layers are plethoric, dull,
and covered with massive yellow-green
membranous deposits. The peritoneal cavity
contains approximately 300 mL of thick
yellow-green fluid. What pathologic process
was detected in the peritoneal cavity?
A. Fibrinopurulent peritonitis
B. Serous peritonitis
C. Serofibrinous peritonitis
D. Peritoneal commissures
E. Fibrinohemorrhagic peritonitis
 Мiкробiологiя
1. To test donor blood for hepatitis B
antigens, it is necessary to use highly sensitive
detection methods. What test should be used
for this purpose?
A. Solid-phase enzyme-linked
immunosorbent assay
B. Immunoelectrophoresis
C. Indirect hemagglutination
D. Complement binding
E. Indirect immunofluorescence
2. The bacteriological laboratory has received
for analysis a sample of dried fish from a focus
of food poisoning outbreak. The bacteriologist
inoculated the sample into a Kitt-Tarozzi
medium, where growth of tennis racquet-
shaped microorganisms could be observed.
These microorganisms are likely to be the
causative agents of:
A. Botulism
B. Salmonellosis
C. Dysentery
D. Staphylococcal toxicoinfection
E. Typhoid fever
3. To determine toxigenicity of diphtheria
causative agents obtained from patients, the
cultures were inoculated in a Petri dish with
nutrient agar, bilaterally to a strip of filter
paper spotted with antidiphtheric antitoxic
serum and situated in the center of the
Petri dish. After incubation of the inoculated
cultures in the agar, strip-like areas of medium
turbidity formed between some of the cultures
and the filter paper. What immunological test
was conducted?
A. Agar gel precipitation test
B. Coombs test
C. Agglutination test
D. Ring precipitin test
E. Opsonization test
4. The bacteriological laboratory needs to
prepare for analysis of materials that are
suspected to be contaminated with spores
of anthrax causative agent. What diagnostic
preparation allows for quick detection of these
spores?
A. Anti-anthrax fluorescent serum
B. Anti-anthrax immunoglobulin
C. Standard anthrax antigen
D. Enzyme-tagged immunoglobulin
E. Monoclonal antibodies to anthrax
causative agent
5. A family has two children. The younger child
is under a year. The child has developed spastic
cough attacks. Similar clinical presentation
was observed in the elder preschool child
one month ago. The doctor suspects pertussis
infection. What method enables retrospective
diagnostics of this disease?
15
A. Serological
B. Bacteriological
C. Biological
D. Microscopy
E. Molecular biological
6. What diagnostic method should be used in
industry to test the raw leather for presence of
B. antracis?
A. Ascoli’s thermo precipitation test
B. Microscopy with Burry-Gins stain
C. Microscopy with Aujeszky stain
D. Bacteriological analysis
E. Serological test
7. Urinalysis of a patient with acute cystitis
shows leukocytes and a large number of gram-
negative bacilli. Inoculation has resulted in
the growth of mucous colonies that produce a
green soluble pigment. What microorganism is
the most likely cause of the patient’s disorder?
A. Pseudomonas aeruginosa
B. Escherihia coli
C. Klebsiella pneumoniae
D. Proteus mirabilis
E. Salmonella enteritidis
8. Pathologic material (mucosal excretion from
the nasal passages) obtained from a patient
provisionally diagnosed with influenza was
sent to the virological laboratory. What quick
test allows detecting specific viral antigen in
the investigated material?
A. Direct and indirect immunofluorescence
(IF)
B. Direct and indirect enzyme-linked
immunosorbent assay (ELISA)
C. Hemagglutination inhibition assay (HAI)
D. Reverse indirect hemagglutination
(RIHA)
E. Radioimmunoassay (RIA)
9. First-year schoolchildren have received
tuberculin skin test (Mantoux test) at the
school nurse’s office. The purpose of this test
was:
A. To determine the children that need to
receive BCG vaccination
B. To preventively vaccinate against
tuberculosis
C. To measure immunity stress due to
diphtheria
D. To measure allergization rate against
rickettsia
E. To detect parotitis in the schoolchildren
10. A 12-year-old boy with clinical
presentation of influenza has developed
respiratory mycoplasmosis. What type
of infection has developed under these
conditions?
A. Mixed infection
B. Iatrogenic infection
C. Superinfection
D. Relapse
E. Autoinfection
 Фармакологiя
1. A patient with peptic ulcer disease was
prescribed famotidine. As a result his gastric
juice acidity significantly decreased. What is
the mechanism of action of this drug?
A. Histamine H2 receptor blockade
B. Histamine H1 receptor blockade
C. Muscarinic M1 receptor blockade
D. Inhibition of H + , K + -ATPase activity
E. Blockade of histamine receptors in the
sympathetic ganglia
2. A 33-year-old woman, who for a long time
has been treated for chronic polyarthritis,
complains of elevated blood pressure,
changes in adipose tissue distribution, and
disturbed menstrual cycle. What drug does
this patient take?
A. Prednisolone
B. Indometacin
C. Butadion (Phenylbutazone)
D. Synaflan (Fluocinolone acetonide)
E. Beclometasone
3. The first-aid center has received a victim
of a traffic accident diagnosed with closed
displaced fracture of the middle third of
the thigh. For repositioning of the bone
fragments the patient received 10 mL of
2% dithylinum solution intravenously, which
resulted in the prolonged period of apnoea
and muscle relaxation. What enzyme is
deficient, resulting in such pharmacogenetic
enzymopathy?
A. Pseudocholinesterase
B. Uridine diphosphate glucuronyltransferase
C. Glucose 6-phosphate dehydrogenase
D. Methemoglobin reductase
E. N-acetyltransferase
4. A patient with diabetes mellitus and
allergic dermatitis was prescribed a certain
fluorinated hormone drug in the ointment
dosage form. When the patient asked, how
this drug was better than the hydrocortisone
ointment, the doctor explained that the
prescribed medicine:
A. Had practically no resorptive effect
B. Increased insulin synthesis
C. Had short-term action
D. Was less potent
E. Was cheaper
5. A 45-year-old woman has an attack of
cardiac fibrillation. She suffers from stage
II essential hypertension. What is the drug of
choice for stopping this attack?
A. Anaprilin (Propranolol)
B. Sustac forte (Nitroglycerin)
C. Potassium chloride
D. Strophanthin
E. Lidocaine
16
6. A patient with inoperable lung cancer
accompanied by unbearable pain was
prescribed an analgesic. Against the
background of analgesic therapy the patient
developed signs of intestinal obstruction.
What analgesic could have caused this
complication?
A. Morphine
B. Promedol (Trimeperidine)
C. Omnopon (Papaveretum)
D. Fentanyl
E. Analgin (Metamizole)
7. A patient has been taking bisacodyl for
a long time to treat chronic constipation.
However, several weeks later the aperient
effect of the drug diminished. What is the
possible cause of this?
A. Acquired tolerance
B. Drug dependence
C. Material cumulation
D. Functional cumulation
E. Sensitization
8. A 39-year-old man presents with
hyperkeratosis, disturbed twilight vision,
and high risk of infectious processes. What
vitamin preparation should he be prescribed?
A. Retinol acetate
B. Pyridoxine hydrochloride
C. Riboflavin
D. Ergocalciferol
E. Tocopherol acetate
9. The neurological department received a
patient complaining of memory deterioration
and loss of mental work capacity that
developed after a head trauma. Recommend
him a medicine for improvement in cerebral
metabolism:
A. Piracetam (Nootropil)
B. Meridil (Methylphenidate)
C. Sydnocarb (Mesocarb)
D. Caffeine
E. Analgin (Metamizole)
10. A woman with polyarticular rheumatoid
arthritis was prescribed a non-steroidal anti-
inflammatory drug - diclofenac sodium.
After the patient has been taking it for some
time, her concomitant disease exacerbated,
which forced the doctor to cancel the
prescription of this drug. What concomitant
disease could necessitate cancellation of this
drug prescription?
A. Ulcer disease
B. Ischemic heart disease
C. Diabetes mellitus
D. Essential hypertension
E. Bronchial asthma
11. A patient with streptococcal infection
 Фармакологiя 17

of the gingiva was prescribed a drug spontaneous respiration the patient received
with β -lactam ring in its structure. What proserin. What pharmacological group does
drug of those listed below belongs to this this drug belong to?
pharmacological group?
A. Cholinesterase inhibitors
A. Benzylpenicillin B. Angiotensin-converting-enzyme inhibitors
B. Rifampicin C. Calcium channel blockers
C. Erythromycin D. Muscarinic antagonists
D. Streptomycin sulfate E. Muscarinic agonists
E. Levomycetin (Chloramphenicol)
16. To treat the burns, a patient was
12. A patient was administered a certain drug prescribed a drug with antiseptic properties
for relief of cardiac rhythm disturbance. This that are based on formation of atomic
drug can be used as a local anesthetic as well. oxygen in the presence of organic substances.
Name this drug: This drug has also an astringent (anti-
inflammatory) effect due to formation of
A. Lidocaine hydrochloride albuminates. Name this drug:
B. Dicain (Tetracaine)
C. Diphenine (Phenytoin) A. Potassium permanganate
D. Cocaine hydrochloride B. Ethyl alcohol
E. Anaesthesin (Benzocaine) C. Sodium bicarbonate
D. Hydrogen peroxide
13. A patient with arrhythmia was E. Chlorhexidine digluconate
hospitalized into the cardiology unit. What
antiarrhythmic drug should be prescribed? 17. Before a surgery the patient was
prescribed a synthetic antiprotozoal drug
A. Amiodarone for prevention of wound infection. The
B. Acetylsalicylic acid prescribed drug is highly effective against
C. Drotaverine hydrochloride Helicobacter pylori. Name this drug:
D. Furacilin (Nitrofural)
E. Diclofenac sodium A. Metronidazole
B. Doxycycline hydrochloride
14. A woman with allergic neurodermatitis C. Chingamin (Chloroquine)
was prescribed a second-generation D. Aciclovir
antihistamine without depressing effect on E. Isoniazid
the CNS. Name this drug:
18. A patient with essential hypertension was
A. Loratadine prescribed a drug that inhibits angiotensin-
B. Diazolin (Mebhydrolin) converting enzyme (ACE). What drug is it?
C. Tavegyl (Clemastine)
D. Dimedrol (Diphenhydramine) A. Lisinopril
E. Ketotifen B. Losartan
C. Nifedipine
15. During gastric resection the patient D. Colestyramine
received mixed anesthesia with tubocurarin E. Carvedilol
chloride muscle relaxant; to restore