MINISTRY OF PUBLIC HEALTH OF UKRAINE

IVANO-FRANKIVSK NATIONAL MEDICAL

UNIVERSITY

STEP - 1
PATHOPHYSIOLOGY

FOR STUDENTS
OF MEDICAL FACULTY

Gerasymchuk M.R.
Pobigun A.A.
Cherkasova V.V.

IVANO-FRANKIVSK
 Gerasymchuk M.R. STEP-1 PATHOPHYSIOLOGY for Students of
Medical faculty / M.R. Gearsymchuk, A.A. Pobigun, V.V. Cherkasova //
IFNMU. Department of pathophysiology. – 2012. – 88 p.

Disscussed and approved on prophil commission of medical&biological

disciplines meeting of Ivano-Frankivsk National Medical University.
Protocol № ___ from «____» ___________ 2012 year

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CONTENT

1. Influence External Factors 5

2. Pathology of hereditary & constitution 5
3. Enzymopathies 11
4. Pathology of Immune Reactivity 13
5. Allergy 16
6. Pathology of Macro- & Microcirculation 20
7. Inflammation 24
8. Pathophysiology of Tumor Growth 27
9. Cell injury 28
10. Starvation & Pathology of Metabolism 30
11. Disorders of Carbohydrate Metabolism 31
12. Disorders of Lipid Metabolism 34
13. Disorders of Water-Electrolite Balance 34
14. Disorders of Acid-Base Balance 38
15. Vitamine Disorders 41
16. Disorders of termoregulation. Fever 44
17. Hipoxia 46
18. Disorders of Respiratory System 47
19. Pathophysiology of Blood. Disorders of RBC. 50
20. Pathophysiology of Blood. Disorders of WBC. 55
21. Disorders of Haemostasis 57
22. Disorders Cardiovascular System 60
23. Disorders of Digestive System 67
24. Liver pathology 70
25. Kidneys pathology 72
26. Disorders of Endocrine System 76
27. Disorders of CNS 82
28. Answers to the Tests 89
29. Recommended Literature 90

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4
 important factor of syndrome
1. Influence of External pathogenesis?
factors A. Increased activity of
anticoagulative system factors
B. Vascular wall damage
1. In result of the damage of one of
C. Thrombocytopenia
the Atomic Power Plant reacttor the
D. Decreased activity of coagulative
run-out of radioelements happened.
factors
People in the increased radiation zone
E. Increased activity of fibrinolysis
were radiated with approximately 250-
factors
300 r. They were immediately
hospitalized. What changes in the
blood count would be typical? 2. Pathology of
A. Neutropenia hereditary & constitution
B. Leukopenia
C. Anemia
5. While studing of the family tree
D. Thrombopenia
with history of hypertrichosis
E. Lymphopenia
(hyperhirsutism of the ear) this sign
was founded only in the men and it was
2. The preventive radioprotector
inherited from father to the son. Define
was given to a worker of a nuclear
the type of hypertrichosis inheritance?
power station. What mechanism from
A. Autosomal-dominant
the below mentioned is considered to
B. Autosomal- recessive
be the main mechanism of
C. Connected with Y-chromosome
radioprotection?
D. Connected with Х-chromosome
A. Increasing of respiration
dominant
B. Inhibition of free radicals
E. Connected with Х-chromosome
formation
recessive
C. Activation of oxidation reactions
D. Prevention of tissue’s hypoxia
6. 46 chromosomes were revealed
E. Increasing of tissue blood supply
on karyotype examination of the 5-year-
old girl. One of the 15th pair of
3. The action of electric current on
chromosomes is longer than usual due
the exitable cell caused depolarization
to connected chromosome from the 21
of its membrane. Movement of what
pair. What type of mutation does this
ions through the membrane caused
girl have?
depolarisation?
A. Deletion
A. Сl-
B. Insufficiency
B. Са2+
C. Inversion
C. Na+
D. Duplication
D. НСО3-
E. Translocation
E. К+
7. Daltonism was diagnosed in a 7-
4. A disaster fighter at a nuclear
year-old boy while prophylactic medical
power plant developed hemorrhagic
examination. Parents are healthy, color
syndrome on the background of acute
vision is normal. Grandfather from the
radiation disease. What is the most
mother's side has the same disorder.
What is the type of inheriting of this
anomaly?
A. Autosomal-recessive
B. Recessive, sex-linked
C. Incomplete domination
D. Autosomal-dominant
E. Dominant, connected with sex
8. Part of the DNA chain turned
about 180 degree due to gamma
radiation. What type of mutation took
place in the DNA chain?
A. Replication
B. Translocation
C. Inversion
D. Doubling
E. Deletion
9. White-haired, with blue eyes girl
was born in healthy parents. Irritability,
anxiety, troubled sleep and feeding
developed in the first months of life of
the infant. What method of genetic
investigation should be used for the
exact diagnosis?
A. Twin
B. Cytological
C. Population-statistical
D. Biochemical
E. Genealogical
10. A 40-year-old pregnant woman
underwent amniocentesis. The
examination of fetus karyotype
revealed 47ХУ+21. What pathology of
the fetus was found out?
A. Schereschevsky-Terner's
disease
B. Patau's disease
C. Phenylketonuria
D. Down's syndrome
E. Klinefelter's syndrome
11. The study of the genealogy of a
family with hypertrichosis (helix
excessive pilosis) demonstrated, that
this feature is manifested in all
generations only in men and is
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inherited by son from his father. What is
the type of hypertrichosis inheritance?
A. Y-linked chromosome
B. X-linked recessive chromosome
C. Autosome-recessive
D. Autosome-dominant
E. X-linked dominant chromosome
12. After the genealogy
analysis a geneticist came to the
conclusion: a feature is manifested in
each generation, men and women
inherit the feature with equal frequency,
parents in the equal way give this
feature to their offspring. What type of
inheritance does the investigated
feature have?
A. Autosomal-dominant
B. Х-linked dominant inheritance
C. Х-linked recessive inheritance
D. Y-linked inheritance
E. Autosomal-recessive
13. Woman applied to the medico-
genetic consulting centre for
information about the risk of
haemophilia in her son. Her husband
has been suffering from this disease
since birth. Woman and her parents are
healthy (don't have haemophilia). Is the
boy likely to have the disease in this
family?
A. 75% of the boys will be ill
B. 25% of the boys will be ill
C. All boys will be ill
D. 50% of the boys will be ill
E. All boys will be healthy
14. The examination of an
youth with mental retardation revealed
eunuchoid body construction and
genitals underdevelopment. The cells
of the oral cavity cantained chromatine.
What method of genetic investigation
should be performed to make more
specified diagnosis?
A. Biochemical
B. Dermatoglyphics
 C. Population-statistic there were no cases of hemophilia in
D. Clinico-genealogical her family. What is the risk of having a
E. Cytological sick child in this family?
A. 25%
15. An 18-year-old man with B. 0
asthenic body constitution: tall, narrow C. 100%
shoulders, broad pelvis and with poor D. 75%
hair on his face came to the geneticist. E. 50%
There was marked mental retardatoin.
The preliminary diagnosis was 19 A woman who was sick with
Klinefelter's syndrome. What method rubella during the pregnancy gave birth
of medical genetics can confirm the to a deaf child with hare lip and cleft
diagnosis? palate. This congenital defect is an
A. Population-statistic example of:
B. Dermatoglyphics A. Genocopy
C. Cytogenic B. Down’s syndrome
D. Gemellary C. Edward’s syndrome
E. Genealogic D. Patau’s syndrome
E. Phenocopy
16. The study of the genealogy of a
family with hypertrichosis (helix 20. A patient, who suffers from
excessive pilosis) has demonstrated congenital erythropoietic porphyria, has
that this symptom is manifested in all skin photosensitivity. The accumulation
generations only in men and is of what compound in the skin can
inherited by son from his father. What cause it?
is the type of hypertrichosis A. Uroporphyrinogen 1
inheritance? B. Uroporphyrinogen 2
A. X-linked recessive chromosome C. Protoporphyrin
B. Autosome-recessive D. Coproporphyrinogen 3
C. X-linked dominant chromosome E. Heme
D. Y-linked chromosome
E. Autosome-dominant 21. An individual is characterized by
rounded face, broad forehead, a
17. A healthy woman has three mongolian type of eyelid fold, flattened
sons affected by color blindness who nasal bridge, permanently open mouth,
were born after her two marriages. projecting lower lip, protruding tongue,
Children both of her husbands are short neck, flat hands, and stubby
healthy. What is the most possible fingers. What diagnosis can be put to
pattern of inheritance of this disease? the patient?
A. X-linked recessive A. Down's syndrome
B. Autosomal recessive B. Turner's syndrome
C. Y-linked C. Klinefelter's syndrome
D. Autosomal dominant D. Supermales
E. X-linked dominant E. Alkaptonuria

18 A couple came for medical 22. Hypertrychosis of auricles is

genetic counseling. The man has caused by a gene that is localized in Y-
hemophilia, the woman is healthy and chromosome. Father has this feature.

7
What is the probability to give birth to 26. Healthy parents have got a fair-
a boy with such anomaly? haired, blue-eyed girl. Irritability,
A. 25% anxiety, sleep and feeding disturbance
B. 0% developed in the first months of the
C. 35% infant's life. Neurological examination
D. 75% revealed developmental lag. What
E. 100% method of genetic investigation should
be used for the exact diagnosis?
23. Objective examination of a A. Cytological
patient revealed: slender figure, big B. Genealogical
skull, highly developed frontal region C. Biochemical
of face, short extremities. What D. Population-statistical
constitutional type is it characteristic E. Gemellary
for?
A. Respiratory 27. Analysis of amniotic fluid that
B. Mixed was obtained as a result of
C. Digestive amniocentesis (puncture of amniotic
D. Cerebral sac) revealed cells the nuclei of which
E. Muscular contain sex chromatin (Barr's body).
What can it be evidence of?
24. A 5-year-old child who often A. Development of male fetus
fells ill with respiratory diseases has B. Genetic disorders of fetus
eczematous appearances after development
consumption of some food products, C. Development of female fetus
tendency to prolonged course of D. Trisomy
inflammatory processes. What kind of E. Polyploidy
diathesis can be suspected in this
case? 28. A woman with 0 (I) bllod group
A. Lymphohypoplastic has born a child with AB blood group.
B. Hemmorhagic This woman's husband has A blood
C. Exudative-catharral group. What genetic interaction
D. Asthenic explains this phenomenon?
E. Arthritism A. Recessive epistasis
B. Codominance
25. A genetics specialist analyzed C. Polymery
the genealogy of a family and found D. Incomplete dominance
that both males and females may E. Complementation
have the illness, not across all the
generations, and that healthy parents 29. Healthy parents have got a fair-
may have ill children. What is the type haired, blue-eyed girl. Irritability,
of illness inheritance? anxiety, sleep and feeding disturbance
A. Y-linked developed in the first months of the
B. Autosomal recessive infant's life. Neurological examination
C. X-linked recessive revealed developmental lag. What
D. Autosomal dominant method of genetic investigation should
E. X-linked dominant be used for the exact diagnosis?
A. Cytological
B. Genealogical

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 C. Biochemical 33. As a result of prophylactic
D. Gemellary medical examination a 7 year old boy
E. Population-statistical was diagnosed with Lesch-Nyhan
syndrome (only boys fall ill with it). The
30. Examination of a patient boy's parents are healthy but his
revealed a strong, balanced, inert type grandfather by his mother's side suffers
of higher nervous activity according to from the same disease. What type of
Pavlov. What temperament type does disease inheritance is it?
the patient have (according to A. Dominant, sex-linked
Hippocrates classification)? B. Semidominance
A. Choleric C. Recessive, sex-linked
B. Melancholic D. Autosomal dominant
C. Sanguine E. Autosomal recessive
D. Phlegmatic
E. - 34. Continuous taking of some drugs
foregoing the pregnancy increase the
31. Autopsy of a newborn boy risk of giving birth to a child with genetic
revealed polydactylia, microcephalia, defects. What is this effect called?
cheiloschisis and uranoschisis as well A. Embryotoxic effect
as hypertrophy of parenchimatous B. Blastomogenic effect
organs. These defects correspond C. Mutagenic effect
with the description of Patau's D. Fetotoxical effect
syndrom e. What is the most probable E. Teratogenic effect
cause of this pathology?
A. Trisomy of the 13th 35. A couple had a child with Down's
chromosome disease. Mother is 42 years old. This
B. Partial monosomy disease is most probably caused by the
C. Trisomy of the 21st following impairment of prenatal
chromosome development:
D. Nondisjunction of sex A. Blastopathy
chromosomes B. Gametopathy
E. Trisomy of the 18th C. Embryopathy
chromosome D. Non-specific fetopathy
E. Specific fetopathy
32. A 32 y.o. man is tall, he has
gynecomastia, adult woman pattern of 36. Examination of a newborn boy's
hair distribution, high voice, mental genitalia revealed an urethral hiatus
deficiency, sterility. Provisional that opens on the undersite of his
diagnosis is Klinefelter's syndrom e. In penis. What malformation is it?
order to specify diagnosis it is A. Cryptorhidism
necessary to analize: B. Monorchism
A. Caryotype C. Epispadia
B. Blood group D. Hermaphroditism
C. Genealogy E. Hypospadias
D. Leukogram
E. Spermatogenesis 37. Cytogenetic examination of a
patient with reproductive dysfunction
revealed normal karyotype 46 ХY in

9
some cells, but most cells have B. Hemorrhagic diathesis
karyotype of Klinefelter's syndrome - C. Lymphohypoplastic diathesis
47 ХХY. Such cell heterogenity is D. Exudative diathesis
called: E. Gouty diathesis
A. Mosaicism
B. Duplication 41 Sex chromosomes of a woman
C. Inversion didn't separate and move to the
D. Monomorphism opposite poles of a cell during
E. Transposition gametogenesis (meiosis). The ovum
was impregnated with a normal
38. A child is pale, pastose, spermatozoon. Which chromosomal
muscular tissue is bad developed, disease can be found in her child?
lymph nodes are enlarged. He often A. Turner's syndrome
suffers from angina and pharyngitis, B. Cat cry syndrome
blood has signs of lymphocytosis. The C. Edwards' syndrome
child is also predisposed to D. Down's syndrome
autoallergic diseases. What type of E. Patau's syndrome
diathesis can be presumed in this
case? 42. Examination of a 12-year-old
A. Exudative boy with developmental lag revealed
B. Gouty achondroplasia: disproportional
C. Asthenic constitution with evident shortening of
D. Hemorrhagic upper and lower limbs as a result of
E. Lymphohypoplastic growth disorder of epiphyseal cartilages
of long tubal bones. This disease is:
39. A family of students who came A. Inherited, sex-linked
from Africa got a child with anemia B. Inherited, dominant
signs. The child died soon. C. Inherited, recessive
Examination revealed that the child's D. Congenital
erythrocytes have abnormal semilunar E. Acquired
shape. Specify genotypes of the
child's parents: 43. Medical examination at the
A. аа х аа military registration and enlistment
B. Аа х аа office revealed that a 15-year-old boy
C. Аа х АА was high, with eunuchoid body
D. АА х АА proportions, gynecomastia, female
E. Аа х Аа pattern of pubic hair distribution. The
boy had also fat deposits on the thighs,
40. A child with a history of no facial hair, high voice, subnormal
frequent angine and pharyngitis has intelligence quotient. Which karyotype
been diagnosed with corresponds with this disease?
lymphadenopathy and splenomegaly. A. 47, XXY
His appearance is characterised by B. 47, XXX
pastosity and paleness, muscular C. 45, XO
tissue is poorly developed. D. 46, XY
Lymphocytosis is present. What kind E. 46, XX
of diathesis is it?
A. Asthenic diathesis

10
 44. A 28-year-old female patient C. Inherited insufficiency of catalase
consulted a gynecologist about D. Inherited insufficiency
sterility. Examination revealed erythrocyte's phosphatdehydrogenase
underdeveloped ovaries and uterus, E. Pus in the wound
irregular menstrual cycle. Analysis of
the sex chromatin revealed 2 Barr’s 48. A child has got galactosemia.
bodies in most somatic cells. What Concentration of glucose in blood has
chromosome disease is most likely? not considerably changed. Deficiency
A. Klinefelter's syndrome of what enzyme caused this illness?
B. Turner's syndrome A. Galactokinase
C. Edwards' syndrome B. Phosphoglucomutase
D. Patau's syndrome C. Amylo-1,6-glucosidase
E. Triple X syndrome D. Galactose-1-phosphate
uridyltransferase
45. One of the parents is suspected E. Hexokinase
of having phenylketonuria recessive
gene. What is the risk of giving birth to 49. While examining the child the
a child with inborn phenylketonuria? doctor revealed symmetric cheeks
A. 75% roughness, diarrhea, disfunction of the
B. 100% nervous system. Lack of what food
C. 0% components caused it?
D. 25% A. Lysine, ascorbic acid
E. 50% B. Threonine, pantothenic acid
C. Methionine, lipoic acid
3. Enzymopathies D. Nicotinic acid, tryptophane
E. Phenylalanine, pangamic acid

46. Patient experienced increased 50. A 13-year-old boy complains of

susceptibility of the skin to the
sunlight. His urine after some time
became dark-red. What is the most
likely cause of this?
A. Pellagra
B. Alkaptonuria
C. Porphyria
D. Albinism
E. Hemolytic jaundice
47. A patient with abscess of the
cut wound applied to
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. Low concentration H2O2
B. Shallow wound
general weakness, dizziness, tiredness.
He is mentally retarded. Increased level
of valine, isoleucine, leucine is in the
blood and urine. Urine has specific
smell. What is the diagnosis?
A. Addison's disease
B. Tyrosinosis
C. Histidinemia
D. Maple syrup urine disease
E. Graves' disease
the 51. Albinos can't stand sun impact
they don't aquire sun-tan but get
sunburns. Disturbed metabolism of
what aminoacid underlies this
phenomenon?
A. Phenilalanine
B. Histidine
C. Tryptophan
D. Methionine

11
 E. Glutamic acid 56. A patient has been diagnosed
with alkaptonuria. Choose an enzyme
52. Blood of a 12 year old boy whose deficiency can be the reason for
presents low concentration of uric acid this pathology:
and accumulation of xanthine and A. Dioxyphenylalanine
hypoxanthine. This child has genetic decarboxylase
defect of the following enzyme: B. Homogentisic acid oxidase
A. Ornithine carbamoyltransferase C. Phenylalanine hydroxylase
B. Arginase D. Glutamate dehydrogenase
C. Xanthine oxidase E. Pyruvate dehydrogenase
D. Glycerylkinase
E. Urease 57. A child suffers from drug
idiosyncrasy. What is the cause of such
53. Examination of a patient reaction?
revealed typical presentations of A. Inhibition of microsomal liver
collagenosis. This pathology is enzymes
characterized by increase of the B. Exhaustion of substrate
following urine index: interacting with pharmaceutical
A. Arginine substance
B. Hydroxyproline C. Hereditary enzymopathy
C. Glucose D. Accumulation of pharmaceutical
D. Mineral salts substance
E. Ammonium salts E. Associated disease of target
organ
54. A newborn child suffers from
milk curdling in stomach, this means 58. A newborn develops dyspepsia
that soluble milk proteins (caseins) after the milk feeding. When the milk is
transform to insoluble proteins substituted by the glucose solution the
(paracaseins) by means of calcium dyspepsia symptoms disappear. The
ions and a certain enzyme What newborn has the subnormal activity of
enzyme takes part in this process? the following enzyme:
A. Pepsin A. Amylase
B. Renin B. Maltase
C. Lipase C. Invertase
D. Secretin D. Isomaltase
E. Gastrin E. Lactase

55. A full-term newborn child has 59. A 46-year-old female patient has
yellowish skin and mucous a continuous history of progressive
membranes. This might be probably muscular (Duchenne's) dystrophy.
caused by temporary deficiency of the Which blood enzyme changes will be of
following enzyme: diagnostic value in this case?
A. Biliverdin reductase A. Pyruvate dehydrogenase
B. Heme synthetase B. Lactate dehydrogenase
C. Uridine transferase C. Creatine phosphokinase
D. Heme oxygenase D. Glutamate dehydrogenase
E. UDPglucoronyltransferase E. Adenylate cyclase

12
 60. 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 high rate of
ganglioside glycometide. What
congenital disease is the child ill with?
A. Tay-Sachs disease
B. Turner's syndrome
C. Wilson's syndrome
D. Niemann-Pick disease
E. MacArdle disease
4. Pathology of
Immune Reactivity
61. In a patient with clinical
signs of immunodeficiency the number
and functional activity of T and B
lymphocytes are not changed. Defect
with dysfunction of antigen-
presentation to the immunocompetent
cells was found during investigation
on the molecule level. Defect of what
cells is the most probable?
A. Т-lymphocytes, В-lymphocytes
B. 0-lymphocytes
C. Fibroblasts, Т-lymphocytes, В-
lymphocytes
D. NK-cells
E. Macrophages, monocytes
62. Live vaccine is injected into the
human body. Increasing activity of
what cells of connective tissue can be
expected?
A. Fibroblasts and labrocytes
B. Adipocytes and adventitious
cells
C. Macrophages and fibroblasts
D. Plasmocytes and lymphocytes
E. Pigmentocytes and pericytes
63. Local lymphonodules enlarged
near the infected wound. Increased
13
amount of macrophages, lymphocytes,
lymphatic follicles in the cortical layer
and large amount of plasma cells were
revealed on histological examination.
What process in the lymphatic nodules
represent these histological changes?
A. Tumour transformation
B. Antigen stimulation
C. Innate insufficiency of the
lymphoid tissue
D. Hypersensibility reaction
E. Acquired insufficiency of the
lymphoid tissue
64. A 12-year-old boy often suffers
from virus and bacterial infections and
eczematous skin lesions. Enlargement
of T-lymphocytes and IgM with normal
IgA and IgG was revealed on
examination. What type of immune
system pathology is presented in the
patient?
A. Bruton's hypogammaglobulinemia
B. Hereditary immundeficiency of the
complement system
C. Composite immunedefficiency
D. Hypoplasia of thymus
E. Turner's syndrome
65. The specimens present sections
of haemopoetic and immunogenetic
organs. Organ has lymph tissue
forming different structures (lymph
nodes,lobules, bars). In what organ
does antigen-independent proliferation
and differantiation take place?
A. Thymus
B. Lymphatic nodes
C. Hemolymph nodes
D. Tonsil
E. Spleen
66. After the radiactive
exposure a patient has stem cells
disorder. The regeneration of what cells
of friable connective tissue will be
damaged?
A. Macrophages
 B. Pericytes
C. Fibroblasts
D. Pigment cells
E. Adipocytes
67. Blood analysis of a patient
showed signs of HIV infection (human
immunodeficiency virus). Which cells
does HIV-virus primarily
A. Specialized nervous cells
(neurons)
B. Mast cells
C. Cells that contain receptor IgM
(B-lymphocytes)
D. Proliferating cells (stem
hematoplastic cells)
E. Cells that contain receptor T4
(T-helpers)
68. A patient with clinical signs of
immunodeficiency has unchanged
number and functional activity of T
and B lymphocytes. Dysfunction's
defect of antigen-presentation to the
immunocompetent cells was found
during investigation on the molecule
level. Defect of what cells is the most
probable here?
A. Fibroblasts, Т-lymphocytes, В-
lymphocytes
B. Т-lymphocytes, В-lymphocytes
C. NK-cells
D. Macrophages, monocytes
E. 0-lymphocytes
69. Examination of cell culture got
from a patient with lysosomal
pathology revealed accumulation of
great quantity of lipids in the
lysosomes. What of the following
diseases is this disturbance typical
for?
A. Tay-Sachs disease
B. Galactosemia
C. Wilson disease
D. Phenylketonuria
E. Gout
70. A patient with clinical
presentations of immunodeficiency
went through immunological
examinations. They revealed
significant loss of cells that form
rosettes with erythrocytes of a ram.
What conclusion can be made
according to the analysis data?
A. Decrease of complement system
rate
B. Decrease of B-lymphocytes rate
C. Insufficiency of effector cells of
humoral immunity
D. Decrease of T-lymphocytes rate
E. Decrease of natural killer cell rate
71. 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. Allotransplantation
B. Isotransplantation
C. Heterotransplantation
D. Autotransplantation
E. Xenotransplantation
72. Continuous taking of some drugs
foregoing the pregnancy increase the
risk of giving birth to a child with genetic
defects. What is this effect called?
A. Embryotoxic effect
B. Blastomogenic effect
C. Mutagenic effect
D. Fetotoxical effect
E. Teratogenic effect
73. It was revealed that T-
lymphocytes were affected by HIV.
Virus enzyme - reverse transcriptase
(RNA-dependent DNA polymerase) -
catalyzes the synthesis of:
A. Virus informational RNA on the
matrix of DNA
B. DNA on virus ribosomal RNA
C. Viral DNA on DNA matrix
D. DNA on the matrix of virus mRNA

14
 E. mRNA on the matrix of virus
protein
74. A child was born with cleft
palate. Examination revealed aorta
defects and reduced number of T-
lymphocytes in blood. What
immunodeficient syndrome is it?
A. Wiskott-Aldrich
B. Chediak-Higashi
C. Louis-Bar
D. Swiss-type
E. DiGeorge
75. 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 significantly
reduce D. Analysis showed also lack
of B-lymphocytes and plasmocytes.
What disease are these symptoms
typical for?
A. Swiss-type
agammaglobulinemia
B. Louis-Bar syndrome
C. Dysimmunoglobulinemia
D. Di George syndrome
E. Bruton's disease
76. A patient suffering from
infectious mononucleosis has been
taking glucocorticosteroids for two
weeks. This resulted in remission but
the patient got exacerbation of chronic
tonsillitis. This complication is induced
by the following effect
glucocorticosteroids:
A. Anti-shock
B. Antitoxic
C. Antiallergenic
D. Immunosuppressive
E. Anti-inflammatory
77. 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 adaptative mechanisms
determined such a low sickness rate of
pupils participating in the sports?
A. Specific adaptation
B. Biochemical adaptation
C. Physiological adaptation
D. Cross adaptation
E. Genetic adaptation
78. After an immunoassay a child
was diagnosed with immunodeficiency
of humoral immunity. What is the
reason for the primary
immunodeficiency development in the
child?
A. Toxic damage of B-lymphocytes
B. Hereditary abnormality of immune
system
C. Pathometabolism in mother's
organism
D. Embryonal development
abnormalities
E. Immune responsiveness and
resistance disorders
79. 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 a chronic process
B. Of exacerbation of a chronic
disease
C. Of primary infection
of D. The woman is healthy
E. Of recurring infection with rubella
virus
80. 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 diseases are
characterized by:
15
 A. Q-febris, epidemic typhus B. Cytolysis, caused by lymphocytes
B. Dysentery, cholera C. Cytotoxic
C. Infectious mononucleosis, AIDS D. Reagin
D. Tuberculosis, mycobacteriosis E. Granulomatosis
E. Poliomyelitis, type A hepatitis
84. A woman complaining of
5. ALERGY coryza, phonastenia, eyelids redness
and lacrymation during spring period
came to the doctor. What type of
81. A 27-year-old woman has allergic reaction by Gell ano Coombs
dropped penicillin containing eye classification develops in this case?
drops. In few minutes there appeared A. Delayed type of hypersensitivity
feeling of itching, burning of the skin, B. Immunocomplex
lips and eyelids edema, whistling C. Stimulating
cough, decreasing of BP. What D. Cytotoxic
antibodies take part in the E. Anaphylactic
development of this allergic reaction?
A. IgA and IgM 85. A child with diphtheria 10 days
B. IgM and IgG after injection of antitoxic antidiphtherial
C. IgM and IgD serum has developed skin rash,
D. IgG and IgD accompanied by severe itch, rising
E. IgE and IgG temperature up to 38*0C and joints
pain. What is the cause of these
82. A patient with paroxysmal symptoms?
attacks of asphyxia, which appear A. Delayed type of hypersensitivity
after inhalation of different aromatic B. Anaphylactic reaction
substances has been made a C. Contact allergy
diagnosis of bronchial asthma. Ig E D. Atopia
rate is elevated. What type of reaction E. Serum sickness
is it the most typical for?
A. Anaphylactic 86. On the 8th day since the
B. Delayed type of hypersensitivity patient was inoculated with antitetanic
C. Autoimmune serum because of dirty wound of his
D. Cytotoxic foot he has developed rising
E. Immunocomplex 0
temperature up to 38 С, pains in the
joints, rash and itch. The blood tests
83. A patient who had been revealed leukopenia and
suffering for many years from thrombocytopenia. Allergic reaction of
bronchial asthma died from asphyxia. what type has developed in this case?
The histological examination of his A. Anaphylactic
lungs revealed the following: much B. Cytotoxic
mucus with eosinophiles contents in C. Delayed type of hypersensitivity
the lumen of bronchioles and small D. Stimulating
bronci, sclerosis of interalveolar septa, E. Immunocomplex
dilation of alveolar lumen. Which of
the mechanisms of allergy 87. A patient visited a dentist with
development is it? complaints of redness and edema of
A. Immunocomplex his mouth mucous membrane in a

16
month after dental prosthesis. The
patient was diagnosed with allergic
stomatitis. What type of allergic
reaction by Gell and Cumbs underlies
this disease?
A. Cytotoxic
B. Delayed type hypersensitivity
C. Anaphylactic
D. Stimulating
E. Immunocomplex
88. Donor skin transplantation was
performed to a patient with extensive
burns. On the 8-th day the graft
became swollen and changed colour;
on the 11-th day graft rejection
started. What cells take part in this
process?
A. B-lymphocytes
B. Erythrocytes
C. T-lymphocytes
D. Basophils
E. Eosinophils
89. 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
eosinophils. What pathogenesis of
bronchial changes is it?
A. Atopy
B. Cytotoxic, cytolytic action of
antibodies
C. Granulomatosis
D. Immunocomplex mechanism
E. Cellular cytolysis
90. Tuberculine was injected
intracutaneously to the child for
tuberculin test. Marked hyperemia,
tissue infiltration developed on the
place of injection in 24 hours. What
mechanism caused these
modifications?
17
A. Cells cytotoxity
B. Reagin type cytotoxity
C. Antibody cytotoxity
D. Granuloma formation
E. Immunocomplex cytotoxity
91. 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 antitoxic immunity to
the tuberculosis
B. Presence of antibodies for
tubercle bacillus
C. Absence of antibodies for
tubercle bacillus
D. Presence of cell immunity to the
tuberculosis
E. Absence of cell immunity to the
tuberculosis
92. A patient has got a spasm of
smooth muscles of bronchi. Activators
of what membrane cytoreceptors are
phisiologically reasoned to stop an
attack?
A. α-adrenoreceptors
B. N-cholinoreceptors
C. α and β-adrenoreceptors
D. M-cholinoreceptors
E. β-adrenoreceptors
93. A woman has been applying a
new cosmetic preparation for a week
that resulted in eye-lid inflammation
accompanied by hyperemia, infiltration
and painfulness. What type of allergic
reaction was developed?
A. III
B. V
C. II
D. I
E. ІV
94. 48 hours after performing
tuberculin test (Mantoux test) to a child
a 10 mm papule appeared on the spot
of tuberculin introduction. What
hypersensitivity mechanism underlies
these changes?
A. Antibody-dependent cytotoxicity
B. Granulomatosis
C. Immune complex cytotoxicity
D. Cellular cytotoxicity
E. Anaphylaxis
95. An experimental animal was
first 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
fibrous structures of connective tissue
in form of mucoid and fibrinoid
swelling and necrosis. What
immunological reaction took place?
A. Immediate hypersensitivity
B. Reaction of transplantation
immunity
C. Delayed-type hypersensitivity
D. Normergic reaction
E. Granulomatosis
96. 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
microscopic 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. Granulomatosis
C. II type (antibody cytotoxicity)
D. I type (reaginic)
E. III type (immune complex
cytotoxicity)
97. In course of histidine catabolism
a biogenic amin is formed that has
powerful vasodilatating effect. Name it:
A. Noradrenalin
B. Dioxyphenylalanine
C. Serotonin
D. Dopamine
E. Histamine
98. A patient was stung by a bee.
Examination 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. Reduced vessel filling
B. Drop of osmotic pressure in tissue
C. Increased vessel permeability
D. Injury of vessels caused by the
sting
E. Drop of oncotic pressure in tissue
99. A female patient underwent liver
transplantation. 1,5 month after it her
condition became worse because of
reaction of transplant rejection. What
factor of immune system plays the
leading part in this reaction?
A. T-killers
B. B-lymphocytes
C. T-helpers
D. Interleukin-1
E. Natural killers
of
100. A patient in a transplantation
centre underwent heart transplantation.
The organ was taken from a donor who
died 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. X-ray therapy
C. Chemotherapy
D. Enzymes
E. Ultrasound
18
 101. A patient with skin mycosis
has disorder of cellular immunity. The
most typical characteristic of it is
reduction of the following index:
A. Plasmocytes
B. Immunoglobulin E
C. Immunoglobulin G
D. B-lymphocytes
E. T-lymphocytes
102. A 50 year old man who was
referred to the hospital for treatment of
cervical lymphadenitis underwent test
for induvidual sensitivity to penicillin.
30 seconds after he went hot all over,
AP dropped down to 0 mm Hg that led
to cardiac arrest. Resuscitation was
unsuccessful. Autopsy results: acute
venous plethora of internal organs;
histological examination of skin (from
the site of injection) revealed
degranulation of mast cells (tissue
basophils). Degranulation was also
revealed in myocardium and lungs.
What type of hypersensitivity reaction
is it?
A. Anaphylactic
B. Complement-mediated cytotoxic
C. Delayed-type hypersensitivity
D. Immunocomplex-mediated
E. -
103. Introduction of a big dose of
histamine to an experimental animal
caused abrupt drop of arterial
pressure as a result of:
A. Constriction of resistance
vessels
B. Dilatation of resistance vessels
C. Increase of heart rate
D. Decrease of heart rate
E. Decrease of heart rate and force
104. Examination of a pregnant
woman having Rh-negative blood
revealed high level of antierythrocytic
antibodies. For its reduction she was
implanted with her husband's Rh-
19
positive skin graft. The graft was
rejected in two weeks. Its microscopic
examination revealed circulatory
disturbance, edema and cellular
infiltration with lymphocytes, neutrophils
and macrophages predominance. What
is the most likely pathology?
A. Interstitial inflammation
B. Delayed-type hypersensitivity
C. Graft immunity
D. Immediate hypersensitivity
E. Granulomatous inflammation
105. During surgical manipulations a
patient has been given novocaine
injection for anesthesia. 10 minutes
later the patient developed paleness,
dyspnea, hypotension. What type of
allergic reaction is it?
A. Cellulotoxic immune reaction
B. Cell-mediated immune reaction
C. Stimulating immune reaction
D. Anaphylactic immune reaction
E. Aggregate immune reaction.
106. 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. Isomerization
B. Decarboxylation
C. Methylation
D. Deaminization
E. Phosphorylation
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 II hypersensitivity reaction
B. Atopic reaction
 C. Arthus phenomenon D. Neurotonic
D. Type IV hypersensitivity reaction E. Metabolic
E. Seroreaction
111. During the expirement
performed on a rabbit the superior
6. Pathology of Macro- cervical node of sympathatic stem was
& Microcyrculation removed. On the side of the extraction
there is redness and rising temperature
of the head skin. What form of
108. Upper neck node of peripheral circulation disorder
sympathetic trunk was removed from developed in this case?
the rabbit on experiment. Reddening A. Neuroparalytic arterial hyperemia
and increased temperature of the skin B. Venous hyperemia
of head is observed. What form of C. Stasis
peripheral circulation of the blood D. Neurotonic arterial hyperemia
developed in the rabbit? E. Metabolic arterial hyperemia
A. Venous hyperemia
B. Stasis 112. Decreased blood supply to
C. Neurotonic arterial hyperemia the organs causes hypoxia that
D. Metabolic arterial hyperemia activates fibroblasts function. Volume of
E. Neuroparalytic arterial what elements is increased in this
hyperemia case?
A. Lymphatic vessels
109. Patient suffering from B. Parenchymatous elements of the
trombophlebitis of the deep veins organ
suddenly died. Autopsy has shown C. Nerve elements
freely lying red friable masses with D. Vessels of microcircular stream
dim crimped surface in the trunk and E. *Intercellular substance
bifurcation of the pulmonary artery.
What pathologic process was 113. During total (with water)
revealed by morbid anatomist? alimentary starvation the generalized
A. Fat embolism edemata have developed. Which of the
B. Thrombosis pathogenic factors is dominant in this
C. Embolism with foreign body case?
D. Tromboembolism A. Reduced oncolitic pressure of
E. Tissue embolism blood plasma
B. Reduced hydrostatic pressure of
110. A 42-year-old woman with interstitial fluid
trigeminal nerve neuralgia complaints C. Reduced osmotic pressure of
of redness of right part of her face and blood plasma
neck, feeling of heat rush and D. Increased oncolitic pressure of
increased dermal sensitiveness. What interstitial fluid
is the arterial hyperemia in this case E. Increased osmotic pressure of
according to pathophysiological interstitial fluid
mechanism?
A. Neuroparalytic 114. The concentration of albumins
B. Reactive in human blood sample is lower than
C. Working

20
normal. This leads to edema of C. Mixed
tissues. What blood function is D. Membranogenic
damaged? E. Lymphogenic
A. Maintaining the body
temperature 118. A 54-year-old man was
B. Maintaining the oncotic blood admitted to the hospital with complaints
pressure of pain in the right subcostal region,
C. Maintaining the blood vomiting with blood. Objectively:
sedimentation system enlarged liver, varicose veins in the
D. Maintaining the Ph level stomach and esophagus. Disfunction of
E. All answers are correct what vessel is likely to be?
A. Vena hepatica
115. A patient suffering from B. Vena cava superior
trombophlebitis of deep veins C. Vena cava inferior
suddenly died. The autopsy has D. Vena porta
shown freely lying red friable masses E. Aorta abdominalis
with dim crimped surface in the trunk
and bifurcation of the pulmonary 119. A patient with thrombophlebitis
artery. What pathologic process was of lower extremities had got chest
revealed by the morbid anatomist? pains, blood spitting, growing
A. Thrombosis respiratory failure that caused his
B. Embolism with foreign body death. Autopsy revealed multiple
C. Tromboembolism pulmonary infarctions. What is the most
D. Fat embolism probable reason of their development?
E. Tissue embolism A. Pulmonary artery thrombosis
B. Bronchial artery embolism
116. The pulmonalis embolism has C. Pulmonary venous thrombosis
suddenly developed in a 40-year-old D. Pulmonary artery embolism
patient with opened fracture of the hip. E. Bronchial artery thrombosis
Choose the possible kind of
embolism: 120. A hypertensive glucose solution
A. Thrombus-embolus was introduced to a patient. It will
B. Fat intensify water movement:
C. Tissue A. From the intercellular liquid to the
D. Air capillaries
E. Foreign body B. From the capillaries to the
intercellular liquid
117. Inflamation is characterised by C. From the cells to the intercellular
increased permeability of vessels of liquid
microcirculation stream, increase of D. From the intercellular liquid to the
their hydrodynamic blood pressure. cells
Increasing of the osmotic E. There will be no changes of water
concentration and dispersity of protein movement
structures is present in the
intercellular fluid. What kind of edema 121. While playing volleyball a
will appear in this case? sportsman made a jump and landed on
A. Colloid-osmotic the outside edge of his foot. He felt
B. Hydrodynamic acute pain in the talocrural joint, active

21
movements are limited, passive removed. Immediately after operation
movements are unlimited but painful. the temperature of ear skm was
A bit later there appeared a swelling in measured. !t was revealed that the
the area of external ankle, the skin temperature of the rabbit's ear skin on
became red and warm. What type of the side of denervation was by 1.5°C
peripheral circulation disturbance is higher than on the opposite intact side.
the case? What of the following is the most
A. Arterial hyperemia probable explanation of the above-
B. Venous hyperemia mentioned effects?
C. Stasis A. Arterial neurotopical hyperemia
D. Embolism B. Atrerial hyperemia induced by
E. Thrombosis metabolic factors
C. Physiological arterial hyperemia
122. A patient with nephrotic D. Arterial neuroparalytic hyperemia
syndrome has massive edemata of his E. Reactive arterial hyperemia
face and limbs. What is the leading
pathogenetic mechanism of edemata 125. Students who are taking
development? examinations often have dry mouth.
A. Increase of vascular The mechanism that causes this state
permeability is the realization of the following
B. Rise of hydrodynamic blood reflexes:
pressure A. Unconditioned peripheral
C. Increase of lymph outflow B. Unconditioned sympathetic
D. Lymphostasis C. Conditioned sympathetic
E. Drop of oncotic blood pressure D. Unconditioned parasympathetic
E. Conditioned parasympathetic
123. 2 hours after a skeletal
extension was performed to a 27 year 126. A patient with obliterating
old patient with multiple traumas atherosclerosis underwent
(closed injury of chest, closed fracture sympathectomy of femoral artery in the
of right thigh) his condition abruptly region of femoral trigone. What type of
became worse and the patient died arterial hyperemia was induced by the
from acute cardiopulmonary operation?
decompensation. Histological A. Functional
examination of pulmonary and B. Neurotonic
cerebral vessels stained with Sudan III C. Metabolic
revealed orange drops occluding the D. Neuroparalytic
vessel lumen. What complication of E. Reactive
polytrauma was developed?
A. Fat embolism 127. A patient ill with
B. Thromboembolism thrombophlebitis of his lower limbs had
C. Gaseous embolism chest pain, blood spitting, progressing
D. Microbal embolism respiratory insufficiency that led to his
E. Air embolism death. Autopsy diagnosed multiple lung
infarctions. What is the most probable
124. A rabbit's nerve that cause of their development?
innervates the right ear was cut and A. Thromboembolism of bronchial
its right superior cervical ganglion was arteries

22
 B. Thrombosis of pulmonary artery 7. INFLAMATION
branches
C. Thrombosis of bronchial arteries
131. Aspirin has antiinflammatory
D. Thrombosis of pulmonary veins
effect due to inhibition of the
E. Thromboembolism of pulmonary
cyclooxygenase activity. Level of what
artery branches
biological active acids will decrease?
A. Biogenic amines
128. A student failed to answer all
B. Catecholamines
the questions of examination paper
C. Prostaglandins
correctly. As a result he blushed, felt
D. Leucotriens
hot and lost confidence. What type of
E. Iodinethyronyns
arterial hyperemia has developed in
this case?
132. Tuberculine was injected
A. Postishemic hyperemia
intraperitoneally to the animal
B. Neurotonic hyperemia
sensibilized with tuberculine. Venous
C. Pathologic hyperemia
hyperemia and peritonial edema were
D. Metabolic hyperemia
detected on the laparotomy in 24 hours.
E. Neuroparalytic hyperemia
Increased amount of lymphocytes and
monocytes were in the smear-print from
129. Autopsy of a 73-year-old man
the peritonium. What pathological
who had been suffering from the
process is in the animal?
coronary heart disease along with
A. Suppurative inflammation
cardiac insufficiency for a long time
B. Fibrinous inflammation
revealed: nutmeg liver, brown
C. Serous inflammation
induration of lungs, cyanotic induration
D. Aseptic inflammation
of kidneys and spleen. What kind of
E. Allergic inflammation
circulation disorder was the cause of
such effects?
133. Necrosis focus appeared in the
A. General acute venous
area of hyperemia and skin edema in
congestion
few hours after burn. What mechanism
B. Acute anaemia
strengthens destructive events in the
C. General chronic venous
inflammation area?
congestion
A. Proliferation of fibroblasts
D. Chronic anaemia
B. Secondary alteration
E. Arterial hyperaemia
C. Primary alteration
D. Emigration of lymphocytes
130. A 45-year-old woman has
E. Diapedesis of erythrocytes
breast cancer. Her left arm has
symptoms of lymphatic system
134. On simulation of inflammation
insufficiency - limb edema, lymph
of the lower extremity the animal
node enlargement. What form of
exrerienced raise of the temperature,
lymphatic circulation insufficiency is it?
increase of amount of antibodies and
A. Combined insufficiency
leucocytes in the blood. What
B. Dynamic insufficiency
substances caused this general
C. Resorption insufficiency
reaction of the organism on
D. Mechanic insufficiency
inflammation?
E. -
A. Glucocorticoid

23
 B. Leucotriens
C. Interleukin
D. Mineralcorticoid
E. Somatomedins
135. Necrosis focus was observed
in the area of hyperemia and skin
edema in a few hours after burn. What
mechanism strengthens destructive
effects in the inflammation area?
A. Proliferation of fibroblasts
B. Diapedesis of erythrocytes
C. Primary alteration
D. Secondary alteration
E. Emigration of lymphocytes
136. Inflamation is characterised by
increasing penetration of vessels of
microcirculation stream, increasing of
their fluid dynamic blood pressure.
Increasing of the osmotic
concentration and dispersity of protein
structures can be found in the
intercellular fluid. What kind of edema
are to be observed in this case?
A. Membranogenic
B. Lymphogenic
C. Mixed
D. Colloid-osmotic
E. Hydrodynamic
137. At the aboratory experiment
the leukocyte culture was mixed with
staphylococci. Neutrophile leukocytes
engulfed and digested bacterial cells.
This processes are termed:
A. Facilitated diffusion
B. Diffusion
C. Osmosis
D. Phagocytosis
E. Pinocytosis
138. 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?
24
A. Autoimmune inflammation
B. Vessels thrombosis
C. Secondary infection
D. Ischemia of myocardium
E. Resorption of enzymes from
necrotized area of myocardium
139. A patient has undergone an
amputation 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 formations relate?
A. Regeneration
B. Dystrophy
C. Hyperemia
D. Inflammation
E. Metaplasia
140. 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. Basophils
B. Monocytes
C. Limphocytes
D. Eosinophils
E. Neutrophils
141. A 17-year-old boy fell seriously
ill, body temperature rose up to 38,50С,
there is cough, rhinitis, lacrimation,
nasal discharges. What kind of
inflammation is it?
A. Fibrinous inflammation
B. Hemorrhagic inflammation
C. Suppurative inflammation
D. Catarrhal inflammation
E. Serous inflammation
142. A 5-year-old child who often
fells ill with respiratory diseases has
eczematous appearances after 146. In course of an experiment a
consumption of some food products, big number of column cells of red bone
tendency to prolonged course of marrow was in some way destructe d.
inflammatory processes. What kind of Regeneration of which cell populations
diathesis can be suspected in this in the loose connective tissue will be
case? inhibited?
A. Exudative-catharral A. Of pericytes
B. Hemmorhagic B. Of fibroblasts
C. Lymphohypoplastic C. Of lipocytes
D. Asthenic D. Of pigment cells
E. Arthritism E. Of macrophags

143. A patient with infectious 147. A 17 year old boy fell seriously
mononucleosis had been taking ill, the body temperature rose up to
glucocorticoids for two weeks. He was 38,5oC there appeared cough, rhinitis,
brought into remission, but he fell ill lacrimation, nasal discharges. What
with acute attack of chronic tonsillitis. inflammation is it?
What action of glucocorticoids caused A. Serous
this complication? B. Purulent
A. Immunosuppressive C. Fibrinous
B. Antiinflammatory D. Hemorrhagic
C. Antishock E. Catarrhal
D. Antiallergic
E. Antitoxic 148. Tuberculine was injected
intraperitoneally to the animal
144. Inflammation of a patient's eye sensibilized with tuberculine. Venous
was accompanied by accumulation of hyperemia and peritonial edema were
turbid liquid with high protein at the detected on the laparotomy in 24 hours.
bottom of anterior chamber that was Increased amount of lymphocytes and
called hypopyon. What process monocytes were in the smear-print from
underlies the changes under the peritonium. What pathological
observation? process is in the animal?
A. Secondary alteration A. Serous inflammation
B. Disturbance of microcirculation B. Suppurative inflammation
C. Primary alteration C. Allergic inflammation
D. Proliferation D. Fibrinous inflammation
E. - E. Aseptic inflammation

145. Utilization of arachidonic acid 149. Inflammatory processes cause

via cyclooxigenase pathway results in synthesis of protein of acute phase in
formation of some bioactive an organism. What substances
substances. Name them: stumulate their synthesis?
A. Somatomedins A. Interleukin-1
B. Biogenic amins B. Angiotensin
C. Thyroxine C. Interferons
D. Prostaglandins D. Immunoglobulins
E. Insulin-like growth factors E. Biogenic amins

25
 150. A 4 year old child complained weight loss, hoarse voice, dyspnea, dry
of pain during deglutition, cough. Laryngoscopy revealed a
indisposition. Objectively: palatine tumour in the pharynx that invaded
arches and tonsils are moderately vocal cords and epiglottis. What is the
edematic and hyperemic, there are most probable cause of tumour
greyish-white films up to 1 mm thick development?
closely adhering to the subjacent A. Nitrosamines
tissues. What pathological process B. Polycyclic aromatic carbohydrates
are these changes typical for? C. Retroviruses
A. Dystrophy D. Ionizing radiation
B. Inflammation E. Aromatic amines and amides
C. Metaplasia
D. Organization 154. An alcoholic woman has born a
E. Necrosis girl with mental and physical
developmental lag. Doctors diagnosed
151. Blood plasma of a healthy the girl with fetal alcohol syndromу.
man contains several dozens of What effect is the cause of the girl's
proteins. During an illness new state?
proteins can originate, namely the A. Malignization
protein of "acute phase". Select such B. Carcinogenic
protein from the listed below: C. Mechanic
A. C-reactive protein D. Teratogenic
B. Prothrombin E. Mutagenic
C. G immunoglobulin
D. Fibrinogen 155. A patient who has been
E. A immunoglobulin abusing tobacco smoking for a long
time has got cough accompanied by
8. Pathophysiology of excretion of viscous mucus; weakness
after minor physical stress, pale skin.
Tumor Growth The patient has also lost 12,0 kg of
body weight. Endoscopic examination
152. A 62 y.o. woman complains of of biosy material his illness was
frequent pains in the area of her chest diagnosed as squamous cell
and backbone, rib fractures. A doctor carcinoma. Name a pathological
assumed myelomatosis process that preceded formation of the
(plasmocytoma). What of the following tumour:
laboratory characteristics will be of the A. Metaplasia
greatest diagnostical importance? B. Hyperplasia
A. Proteinuria C. Hypoplasia
B. Hypoproteinemia D. Sclerosis
C. Hypoglobulinemia E. Necrosis
D. Hyperalbuminemia
E. Paraproteinemia 9. Cell ingury
153. A 62 year old patient who
156. Due to action of electric current
previously worked as stoker was
on the exitable cell there appeared
admitted to a hospital with complaints
depolarization of it's membrane.
about general weakness, abrupt

26
Movement of what ions through the
membrane caused depolarisation?
A. НСО3-
B. Na+
C. Са2+
D. Сl-
E. К+
157. During metabolic process,
active forms of the oxygen including
superoxide anion radical are formed in
the human body. With help of what
enzyme is this anion activated?
A. Peroxidase
B. Glutathioneperoxidase
C. Superoxide dismutase
D. Catalase
E. Glutathionereductase
158. Highly injured person
gradually died. Please choose the
indicator of biological death:
A. Disarray of chemical processes
B. Loss of consciousness
C. Absence of palpitation
D. Autolysis and decay in the cells
E. Absence of movements
159. Due to activation of ion
channels of external membrane of
excitable cell it's rest potential has
significantly increased. What channels
were activated?
A. Fast calcium channels
B. Potassium channels
C. Natrium and calcium channels
D. Slow calcium channels
E. Natrium channels
160. Carnitine including drug was
recomended to the sportsman for
improving results. What process is
activated most of all with help of
carnitine?
A. Synthesis of ketone bodies
B. Synthesis of lipids
C. Tissue respiration
27
D. Transport of fatty acids to the
mitochondria
E. Synthesis of steroid hormones
161. Low level of albumins and
fibrinogen was detected in the patient's
blood. Decreased activity of what
organelle of the liver hepatocytes can
cause it?
A. Mitochondrions
B. Golgi complex
C. Lysosomes
D. Granular endoplasmatic net
E. Agranular endoplasmatic net
162. The penetration of the irritable
cell membrane for potassium ions has
been increased during an experiment.
What changes of membrane electric
status can occur?
A. Local response
B. Action potential
C. No changes
D. Depolarization
E. Hyperpolarization
163. 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. Increasing of respiration
B. Inhibition of free radicals
formation
C. Activation of oxidation reactions
D. Prevention of tissue’s hypoxia
E. Increasing of tissue blood supply
164. 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. Diacylglycerol
B. CAMP
C. Inositol-3,4,5-triphosphate
D. Ca2+
 E. Glycerol C. Wilson disease
D. Tay-Sachs disease
165. During the experiment on the E. Galactosemia
influence of chemical substances in
the muscles the reaction of Ca2+-pump 169. Normal, actively dividing cells
is weakened. Which phenomenum will of human red bone marrow are
be observed? analyzed. What number of cells'
A. Decreased velocity of the AP chromosomes is typical for G1 period?
distribution A. 46
B. Activation of the sodium- B. 48
potassium pump C. 23
C. Prolonged relaxation D. 45
D. Decreased AP E. 47
E. Prolonged duration of the AP
170. An isolated muscle fiber is
166. A patient who was previously under examination. It was established
ill with mastectomy as a result of that the threshold of stimulation force
breast cancer was prescribed became significantly lower. What is the
radiation therapy. What vitamin cause of this phenomenon?
preparation has marked A. Inactivation of sodium channels of
radioprotective action caused by membrane
antioxidant activity? B. Inactivation of potassium
A. Thiamine chloride channels of membrane
B. Ergocalciferol C. Block of energy production in the
C. Tocopherol acetate cell
D. Riboflavin D. Activation of potassium channels
E. Folic acid of membrane
E. Activation of sodium channels of
167. ATP synthesis is totaly membrane
blocked in a cell. How will the value of
membrane rest potential change? 171. Labelled amino acids alanine
A. It will be slightly increased and tryptophane were injected to a
B. First it will increase, then mouse in order to study localization of
decrease protein synthesis in its cells. The
C. First it will decrease, then labelled amino acids will be
increase accumulated near the following
D. It will be considerably increased organellas:
E. It will disappear A. Ribosomes
B. Smooth endoplasmic reticulum
168. Examination of cell culture got C. Cell centre
from a patient with lysosomal D. Golgi apparatus
pathology revealed accumulation of E. Lysosomes
great quantity of lipids in the
lysosomes. What of the following 172. Study of conversion of a food
diseases is this disturbance typical colouring agent revealed that
for? neutralization of this xenobiotic takes
A. Gout place only in one phase - microsomal
B. Phenylketonuria

28
oxydation. Name a component of this E. With domination of proteins and
phase: fat
A. Cytochrome C
B. Cytochrome B 176. A 4 y.o. child with signs of
C. Cytochrome A durative proteinic starvation was
D. Cytochrome Р-450 admitted to the hospital. The signs
E. Cytochrome oxidase were as follows: growth inhibition,
anemia, edemata, mental deficiency.
173. As a result of activation of the Choose a cause of edemata
ion channels of the external development:
membrane the rest potential of an A. Reduced synthesis of hemoglobin
excitable cell has greatly increased. B. Reduced synthesis of albumins
What channels were activated? C. Reduced synthesis of lipoproteins
A. Sodium and calcium channels D. Reduced synthesis of globulins
B. Fast calcium channels E. Reduced synthesis of
C. Potassium channels glycoproteins
D. Sodium channels
E. Slow calcium channels 177. As a result of long-term
starvation the glomerular filtration of a
174. There are several groups of man was accelerated by 20%. The
molecular mechanisms playing most probable cause of filtration
important part in pathogenesis of changes under such conditions is:
insult to cells which contributes to the A. Rise of systemic arterial pressure
pathology development. What B. Growth of filtration coefficient
processes are stimulated by proteinic C. Increase of renal plasma flow
damage mechanisms? D. Increased permeability of renal
A. Acidosis filter
B. Phospholipase activation E. Fall of oncotic pressure of blood
C. Osmotic membrane distension plasma
D. Lipid peroxidation
E. Enzyme inhibition 178. Power inputs of a boy
increased from 500 to 2000 kj pro hour.
10. Starvation & What can be the cause of it?
A. Transition from sleep to
Pathology of Metabolism wakefulness
B. Mental activity
175. Respiratory coefficient was C. Raise of outer temperatute
studied in the patient who strictly kept D. Physical exercise
certain diet for 10 days. It was E. Food intake
determined that it is 1. What diet does
the patient follow? 179. Long-term starvation cure of a
A. With domination of fat and patient resulted in diminished ratio of
carbohydrates albumines and globulines in plasma.
B. With domination of proteins and What of the following will be result of
carbohydrates these changes?
C. With domination of A. Increase of hematocrit
carbohydrates B. Increase of ESR
D. Mixed C. Decrease of hematocrit

29
 D. Hypercoagulation
E. Decrease of ESR
180. Dietary intake of a 30 year old
nursing 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 following way:
A. To increase calcium content
B. To reduce fluorine content
C. To reduce iron content
D. To increase iron content
E. To increase phosphorus content
181. When measuring power inputs
of a man by the method of indirect
calorimetry 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. 1,0
B. 0,9
C. 0,8
D. 1,25
E. 0,84
182. During starvation muscle
proteins break up into free amino
acids. These compounds will be the
most probably involved into the
following process:
A. Synthesis of higher fatty acids
B. Glycogenolysis
C. Decarboxylation
D. Gluconeogenesis in liver
E. Gluconeogenesis in muscles
183. As a result of continuous
starvation the glomerular filtration rate
has increased by 20%. The most
probable cause of the glomerular
filtration alteration under the
mentioned conditions is:
A. Increase in the permeability of
the renal filter
30
B. Decrease in the oncotic pressure
of blood plasma
C. Increase in the systemic arterial
pressure
D. Increase of the filtartion quotient
E. Increase of the renal blood flow
11. Disorders of
Carbohydrate Metabolism
184. On the empty stomach in the
patients blood glucose level was 5,65
mmol/L, in an hour after usage of sugar
it was 8,55 mmol/L, in a 2 hours - 4,95
mmol/L. Such indicators are typical for:
A. Patient with non-insulin
dependent diabetes mellitus
B. Patient with insulin-dependent
diabetes mellitus
C. Patient with tireotoxicosis
D. Patient with hidden diabetes
mellitus
E. Healthy person
185. Patient with diabetes didn't get
insulin injection in time that caused
hyperglycemic coma (glucose in the
blood 50mmol/L). What mechanism is
prevalent in the development of the
coma?
A. Hypokaliemia
B. Hypoxia
C. Hyperosmia
D. Hyponatremia
E. Acidosis
186. The B cells of endocrine portion
of pancreas are selectively damaged by
alloxan poisoning. How will it be
reflected in blood plasma?
A. The content of globulins
decreases
B. The content of albumins
decreases
C. The content of fibrinogen
decrease
D. The level of sugar decreases
 E. The content of sugar increases A. Ketone bodies
B. Monosaccharides
187. A patient with the symptoms C. Cholesterol esters
of acute alcoholic poisoning was D. High fatty acids
brought to the hospital. What E. Amino acids
carbohydrates metabolism changes
are typical for this condition? 191. Diabetes mellitus causes
A. The anaerobic glucose ketosis as a result of activated
metabolism predominates in muscles oxidation of fatty acids. What disorders
B. The gluconeogenesis is of acid-base equilibrium may be caused
increased in liver by excessive accumulation of ketone
C. The breakage of glycogen is bodies in blood?
increased in liver A. Respiratory acidosis
D. The gluconeogenesis velocity in B. Metabolic alcalosis
liver is decreased C. Any changes woun't happen
E. The anaerobic breakage of D. Metabolic acidosis
glucose is increased in muscles E. Respiratory alcalosis

188. Patient with diabetes mellitus 192. A patient was delivered to the
experienced loss of consciousness hospital by an emergency team.
and convulsions after injection of Objectively: grave condition,
insulin. What is the result of unconscious, adynamy. Cutaneous
biochemical blood analysis for surfaces are dry, eyes are sunken, face
concentration of the sugar? is cyanoti c. There is tachycardia and
A. 10,0 mmol/L smell of acetone from the mouth.
B. 3,3 mmol/L Analysis results: blood glucose - 20,1
C. 5,5 mmol/L micromole/l (standard is 3,3-5,5
D. 1,5 mmol/L micromole/l), urine glucose - 3,5%
E. 8,0 mmol/L (standard is - 0). What is the most
probable diagnosis?
189. The gluconeogenesis is A. Acute alcoholic intoxication
activated in the liver after intensive B. Anaphylactic shock
physical trainings .What substance is C. Hyperglycemic coma
utilized in gluconeogenesis first of all D. Acute heart failure
in this case: E. Hypoglycemic coma
A. Glucose
B. Glutamate 193. A child is languid, apathetic.
C. Alanine Liver is enlarged and liver biopsy
D. Lactate revealed a significant excess of
E. Pyruvate glycogene. Glucose concentration in
the blood stream is below normal. What
190. The patient with diabetes is the cause of low glucose
mellitus has been delivered in hospital concentration?
in the state of unconsciousness. A. Low (absent) activity of
Arterial pressure is low. The patient hexokinase
has acidosis. Point substances, which B. High activity of glycogen
accumulation in the blood results in synthetase
these manifestations:

31
 C. Deficit of a gene that is
responsible for synthesis of glucose 1-
phosphaturidine transferase
D. Low (absent) activity of
glycogene phosphorylase in liver
E. Low (absent) activity of glucose
6-phosphatase
194. 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
examination)?
A. C-reactive protein
B. Ceruloplasmin
C. Fibrinogen
D. Albumin
E. Glycated hemoglobin
195. An experimental animal has
been given excessive amount of
carbon-labeled glucose for a week.
What compound can the label be
found in?
A. Choline
B. Methionine
C. Palmitic acid
D. Vitamin A
E. Arachidonic acid
196. 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. Lysosomal glycosidase
C. Gamma amylase
D. Glucose 6-phosphate
dehydrogenase
E. Alpha amylase
197. 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. Intensification of glucose
absorption in the bowels
B. Inhibition of glycogen synthesis
C. Gluconeogenesis activation
D. Glycogenogenesis activation
E. Activation of insulin
decomposition
198. A 12-year-old teenager has
significantly put off weight within 3
months; glucose concentration rose up
to 50 millimole/l. He fell into a coma.
What is the main mechanism of its
development?
A. Hypoglycemic
B. Ketonemic
C. Hypoxic
D. Lactacidemic
E. Hyperosmolar
12. Disorders of Lipid
Metabolism
199. A 65-year-old man with
signs of profuse obesity and risk of fatty
liver dystrophy was recommended
high-lipotropic diet. The contents of
what substance in his diet is the most
effective in this case?
A. Glycin
B. Methionine
C. Glucose
D. Cholesterol
E. Vitamin C
200. A 70 year old man is ill with
vascular atherosclerosis of lower
extremities and coronary heart disease.
Examination revealed disturbance of

32
lipidic blood composition. The main
factor of atherosclerosis pathogenesis
is the excess of the following
lipoproteins:
A. Low-density lipoproteins
B. Intermediate density lipoproteins
C. Cholesterol
D. High-density lipoproteins
E. Chylomicrons
201. Increased amount of free fat
acids is observed in the blood of the
patients with diabetes mellitus. It can
be caused by:
A. Activation of the ketone bodies
utilization
B. Activation of the synthesis of the
apolipoproteins
C. Increased activity of
triglyceridelipase adipocytes
D. Storage of palmitatoil-CoA
E. Decreased activity of
phosphatidylcholine-cholesterol-
acyltransferase blood plasma
13. Disorders of
Water-Electrolite Balance
202. Inflamation is characterised by
increasing penetration of vessels of
microcirculation stream, increasing of
their fluid dynamic blood pressure.
Increasing of the osmotic
concentration and dispersity of protein
structures present in the intercellular
fluid. What kind of edema will appear
in this case?
A. Hydrodynamic
B. Lymphogenic
C. Membranogenic
D. Colloid-osmotic
E. Mixed
33
203. Periodic renal colics attackes
are observed in the woman with
primery hyperparathyroidizm.
Ultrasonic examination revealed small
stones in the kidneys. What is the
cause of the formation of the stones?
A. Hypercholesterinemia
B. Hyperkalemia
C. Hypercalcemia
D. Hyperphosphatemia
E. Hyperuricemia
204. A 56-year-old patient with
cardiac failure notices edematous feet
and shins, the skin in the place of
edema is pale and cold. What is the
leading pathogenesis of this patient's
edema?
A. Increased hydrostatic pressure in
venulaes
B. Reduced oncotic pressure in
capillaries
C. Lymph outflow impairment
D. Increased capillary penetration
E. Positive water balance
205. During total (with water)
alimentary starvation the generalized
edemata have developed. Which of the
pathogenic factors is dominant in this
case?
A. Reduced oncolitic pressure of
blood plasma
B. Reduced hydrostatic pressure of
interstitial fluid
C. Reduced osmotic pressure of
blood plasma
D. Increased oncolitic pressure of
interstitial fluid
E. Increased osmotic pressure of
interstitial fluid
206. Chronic glomerulonephritis was
diagnosed in a 34-year-old patient 3
years ago. Edema has developed for
the last 6 months. What caused it?
A. Hyperosmolarity of plasma
B. Hyperproduction of vasopressin
 C. Proteinuria
D. Disorder the livers protein
formation function
E. Hyperaldosteronism
207. A 50-year-old patient
complains of thirst, drinking of a lot of
water, marked polyuria. Blood glucose
is 4,8 mmol/L, urine glucose and
acetone bodies are absent, urine is
colorless, specific gravity is 1,002-
1,004. What is the cause of polyuria?
A. Hypothyroidism
B. Thyrotoxicosis
C. Aldosteronism
D. Vasopressin insufficiency
E. Insulin insufficiency
208. 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. Cortisol
D. Parathormone
E. Natriuretic
209. A 2-year-old child experienced
convulsions because of lowering
calcium ions concentration in the
blood plasma. Function of what
structure is decreased?
A. Pineal gland
B. Thymus
C. Hypophysis
D. Adrenal cortex
E. Parathyroid glands
210. Glomerular filtration rate
(GFR) increased by 20% due to
prolonged starvation of the person.
The most evident cause of filtration
changes under this conditions is:
A. Increase of filtration coefficient
B. Increase of penetration of the
renal filter
34
C. Decrease of oncotic pressure of
blood plasma
D. Increase of systemic blood
pressure
E. Increase of renal plasma stream
211. 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 body temperature
B. Maintaining the oncotic blood
pressure
C. Maintaining the blood
sedimentation system
D. Maintaining the Ph level
E. All answers are correct
212. 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. Baroreceptors of aortic arch
C. Osmoreceptors of liver
D. Sodium receptors of
hypothalamus
E. Glucoreceptors of hypothalamus
213. A patient who suffers from
heart failure has enlarged liver,
edemata of lower extremities, ascites.
What is the leading mechanism in the
development of this edema?
A. Lymphogenous
B. Membranogenic
C. Hydrodynamic
D. Colloid osmotic
E. –
214. Osmotic pressure of a man's
blood plasma is 350 mosmole/l
(standard pressure is 300 mosmole/l).
First of all it will result in high secretion
of the following hormone:
A. Aldosteron
B. Cortisol
C. Adrenocorticotropin
 D. Vasopressin
E. Natriuretic
215. A patient has a decreased
vasopressin synthesis that causes
polyuria and as a result of it evident
organism dehydratation. What is the
mechanism of polyuria development?
A. Acceleration of glomerular
filtration
B. Reduced tubular reabsorption of
protein
C. Reduced tubular reabsorption of
Na ions
D. Reduced glucose reabsorption
E. Reduced tubular reabsorption of
water
216. A patient ill with enteritis
accompanied by massive diarrhea has
low water rate in the extracellular
space, high water rate inside the cells
and low blood osmolarity. What is
such disturbance of water-electrolytic
metabolism called?
A. Hyperosmolar hypohydration
B. Hypo-osmolar hyperhydration
C. Hypo-osmolar hypohydration
D. Hyperosmolar hyperhydration
E. Osmolar hypohydration
217. As a result of long-term
starvation the glomerular filtration of a
man was accelerated by 20%. The
most probable cause of filtration
changes under such conditions is:
A. Rise of systemic arterial
pressure
B. Growth of filtration coefficient
C. Increase of renal plasma flow
D. Increased permeability of renal
filter
E. Fall of oncotic pressure of blood
plasma
218. A patient with nephrotic
syndrome has massive edemata of his
face and limbs. What is the leading
35
pathogenetic mechanism of edemata
development?
A. Increase of vascular permeability
B. Rise of hydrodynamic blood
pressure
C. Increase of lymph outflow
D. Lymphostasis
E. Drop of oncotic blood pressure
219. A concentrated solution of
sodium chloride was intravenously
injected to an animal. This caused
decreased reabsorption of sodium ions
in the renal tubules. It is the result of
the following changes of hormonal
secretion:
A. Aldosterone increase
B. Vasopressin increase
C. Aldosterone reduction
D. Vasopressin reduction
E. Reduction of atrial natriuretic
factor
220.Decreased blood supply to the
organs causes hypoxia that activates
fibroblasts function. Volume of what
elements is increased in this case?
A. Nerve elements
B. Parenchymatous elements of the
organ
C. Lymphatic vessels
D. Intercellular substance
E. Vessels of microcircular stream
221. A hypertensive glucose solution
was introduced to a patient. It will
intensify water movement:
A. From the intercellular liquid to the
cells
B. From the cells to the intercellular
liquid
C. From the intercellular liquid to the
capillaries
D. From the capillaries to the
intercellular liquid
E. There will be no changes of water
movement
 222. A patient was stung by a bee.
Examination 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. Reduced vessel filling
B. Drop of osmotic pressure in
tissue
C. Increased vessel permeability
D. Injury of vessels caused by the
sting
E. Drop of oncotic pressure in
tissue
223. A man weighs 80 kg, after
long physical 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 determined first of
all by:
A. Water loss with sweat
B. Increased diuresis
C. Increased number of
erythrocytes
D. Increased circulating blood
volume
E. Increased protein concentration
in plasm
224. 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 decreased,
reabsorption - increased
B. Both filtration and reabsorption
will be decreased
C. Both filtration and reabsorption
will be increased
D. Exchange will stay unchanged
E. Filtration will be increased,
reabsorption - decreased
36
225. A patient was admitted to the
infectious department. His symptoms:
dry skin, decreased skin turgor, rice-
water stool. The patient was diagnosed
with choler A. What disorder of water-
electrolytic balance is most often
observed in this disease?
A. Hyperosmotic hyperhydration
B. Hyperosmotic hypohydration
C. Hypoosmotic hypohydration
D. Hypoosmotic hyperhydration
E. Isoosmotic hypohydration
226. 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. Increase of capillary permeability
B. Rise of hydrostatic pressure in
venules
C. Drop of oncotic pessure in
capillaries
D. Disorder of lymph outflow
E. Positive water balance
227. 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. Metabolism will stay unchanged
B. Filtration will be increased,
reabsorption - decreased
C. Both filtration and reabsorption
will be increased
D. Filtration will be decreased,
reabsorption - increased
E. Both filtration and reabsorption
will be decreased
228. A patient with enteritis
accompanied by massive diarrhea has
low water rate in the extracellular
space, high water rate inside the cells
and low blood osmolarity. What is such
disturbance of water-electrolytic
metabolism called?
A. Hypo-osmolar hyperhydration
B. Hypo-osmolar hypohydration
C. Hyperosmolar hyperhydration
D. Hyperosmolar hypohydration
E. Osmolar hypohydration
14. Disorders of Acid-
Base Balance
232. 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. Respiratory acidosis
B. Metabolic alcalosis
C. Any changes woun't happen
D. Metabolic acidosis
E. Respiratory alcalosis

229. Index of pH of the blood 233. A pregnant woman had been

changed and became 7,3 in the having toxicosis with severe repeated
patient with diabetus mellitus. vomiting for 24 hours. In the end of the
Detecting of the components of what day there appeared tetanic convulsions
buffer system is used while and fluid loss. What shift of acid-base
diagnosing disorder of the acid-base state caused these changes?
equilibrium? A. Gaseous acidosis
A. Protein B. Metabolic acidosis
B. Oxyhemoglobin C. Excretory alkalosis
C. Phosphate D. Gaseous alkalosis
D. Hemoglobin E. Excretory acidosis
E. Bicarbonate
234. A group of mountain climbers
230. Disorder of the airways went through the blood analysis at the
passage in small and middle bronchi height of 3000 m. It revealed decrease
was revealed in the patient. What of HCO3 to 15 micromole/l (standard is
disorder of the acid-base equilibrium 22-26 mmole/l). What is the mechanism
can be detected in the blood? of HCO3 decrease?
A. Respiratory alkalosis A. Hyperventilation
B. Metabolic alkalosis B. Decrease of bicarbonate
C. Metabolic acidosis reabsorption in kidneys
D. Respiratory acidosis C. Hypoventilation
E. – D. Decrease of ammoniogenesis
E. Intensification of acidogenesis
231. A child, suffering from
pylorostenosis accompanied by 235. As a result of exhausting
frequent vomiting, developed signs of muscular work a worker has largely
dehydration. What form of acid-base reduced buffer capacity of blood. What
disbalance can develop in this case? acidic substance that came to blood
A. Gaseous alkalosis caused this phenomenon?
B. Gaseous acidosis A. Pyruvate
C. Nongaseous acidosis B. 1.3-bisphosphoglycerate
D. Nongaseous alkalosis C. Lactate
E. Metabolic acidosis D. 3-phosphoglycerate
E. –

37
 236. An infant has apparent
diarrhea resulting from improper
feeding. One of the main diarrhea
effects is plentiful excretion of sodium
bicarbonate. What form of acid-base
balance disorder is the case?
A. Respiratory alkalosis
B. Respiratory acidosis
C. No disorders of acid-base
balance will be observed
D. Metabolic acidosis
E. Metabolic alkalosis
237. Buffer capacity of blood was
decreased in the worker due to
exhausting muscular work. Entry of
what acid substance to the blood can
this state be explained?
A. 1,3-bisphosphoglycerate
B. Alpha-ketoglutarate
C. 3-phosphoglycerate
D. Lactate
E. Pyruvate
238. Analysis of blood serum of a
patient revealed increase of alanine
aminotransferase and aspartate
aminotransferase level. What
cytological changes can cause such a
situation?
A. Disturbance of genetic
apparatus of cells
B. Cellular breakdown
C. Disorder of enzyme systems of
cells
D. Disturbance of cellular
interrelations
E. Disturbed function of energy
supply of cells
239. Untrained people often have
muscle pain after sprints as a result of
lactate accumulation. This might be
caused by intensification of the
following biochemical process:
A. Lipogenesis
B. Glycogenesis
C. Pentose phosphate pathway
38
D. Glycolysis
E. Gluconeogenesis
240. When blood circulation in the
damaged tissue is restored, then
lactate accumulation comes to a stop
and glucose consumption decelerates.
These metabolic changes are caused
by activation of the following process:
A. Gluconeogenesis
B. Aerobic glycolysis
C. Glycogen biosynthesis
D. Lipolysis
E. Anaerobic glycolysis
241. A 48 year old patient
complained about intense pain, slight
swelling and reddening of skin over the
joints, temperature rise up to 38oC.
Blood analysis revealed high
concentration of urates. This condition
might be caused by disturbed
metabolism of:
A. Collagen
B. Pyrimidines
C. Cholesterol
D. Carbohydrates
E. Purines
242. 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. Phosphoric calcium metabolism
B. Water-salt metabolism
C. Amino-acid metabolism
D. Carbohydrate metabolism
E. Lipidic metabolism
243. An infant has pylorospasm,
weakness, hypodynamia, convulsions
as a result of frequent vomiting. What
kind of acid-base disbalance is it?
A. Excretory acidosis
B. Metabolic acidosis
 C. Excretory alkalosis 247. A patient has got frequent
D. Gaseous alkalosis internal organs' and mucosal
E. Exogenous nongaseous hemorrhages. The analysis indicated
acidosis insufficiency of hydroxyproline and
hydroxylysine in the collagenous fibres.
244. A 46-year-old patient The insufficiencuy of what vitamin
consulted a doctor complaining about caused the impairment of
joint pain that becomes stronger the hydroxylysation of abovementioned
day before the weather changes. aminoacids in a patient?
Blood examination revealed an A. Vitamin Н
increased concentration of uric acid. B. Vitamin К
The most probable cause of the C. Vitamin С
disease is the intensified D. Vitamin РР
disintegration of the following E. Vitamin А
substance:
A. Uridine triphosphate 248. A woman, who was keeping
B. Adenosine monophosphate a diet for a long time and eating refined
C. Thymidine monophosphate rice, has developed polyneuritis
D. Uridine monophosphate (beriberi disease). The absence of what
E. Cytidine monophosphate vitamin in the diet causes the
development of such disease?
245. A newborn child with A. Ascorbic acid
pylorostenosis has often repeating B. Pyridoxal
vomiting accompanied by apathy, C. Riboflavin
weakness, hypertonicity, sometimes D. Folic acid
convulsions. What disorder form of E. Thiamine
acid-base balance is it?
A. Metabolic acidosis 249. A 35-year-old woman with
B. Excretory acidosis chronic renal disease has developed
C. Nongaseous alkalosis osteoporosis. Deficiency of which from
D. Gaseous acidosis the belowmentioned substances
E. Gaseous alkalosis causes such complication?
A. 25OHD3
15. Vitamine Disorders B. Cholesterol
C. D2
D. D3
246. Pain along large nervous
E. 1.25(OH)2 D3
stems and increased amount of
pyruvate in the blood were revealed in
250. A 43-year-old man suffers
the patient. Insufficiency of what
from chronic atrophic gastritis and
vitamin can cause such change?
megaloblastic hyperchromic anemia.
A. Pantothenic acid
He also has methylmalonic aciduria.
B. В1
Insufficiency of what vitamin led to the
C. РР
development of such complex of
D. Biotin
symptoms?
E. В2
A. Vitamin В3
B. Vitamin В12
C. Vitamin В2

39
 D. Vitamin В1
E. Vitamin В5
251. A patient with symmetric
dermatitis of open dermal areas came
to the doctor. Talking to the patient the
doctor found out that the patient
mostly eats cereals and eats little
meat, milk and eggs. The deficiency of
which of the mentioned vitamins is
dominant in this patient?
A. Folic acid
B. Tocopherol
C. Calciferol
D. Nicotinamide
E. Biotin
252. There is an inhibited
coagulation in the patients with bile
ducts obstruction, bleeding due to the
low level of absorbtion of a vitamin.
What vitamin is in deficiency?
A. К
B. Е
C. D
D. А
E. Carotene
253. A 2-year-old child has got
intestinal dysbacteriosis, which results
in hemorrhagic syndrome. What is the
most likely cause of hemorrhage of
the child?
A. Activation of tissue
thromboplastin
B. PP hypovitaminosis
C. Fibrinogen deficiency
D. Vitamin K insufficiency
E. Hypocalcemia
254. Pyruvate concentration in the
patient’s urine has increased 10 times
from normal amount. What vitamin
deficiency can be the reason of this
change:
A. Vitamin B6
B. Vitamin A
C. Vitamin E
40
D. Vitamin C
E. Vitamin B1
255. Hydroxylation of endogenous
substrates and xenobiotics requires a
donor of protons. Which of the following
vitamins can play this role?
A. Vitamin C
B. Vitamin E
C. Vitamin P
D. Vitamin A
E. Vitamin B6
256. Most participants of Magellan
expedition to America died from
avitominosis. This disease declared
itself by general weakness,
subcutaneous hemmorhages, falling of
teeth, gingival hemmorhages. What is
the name of this avitiminosis?
A. Biermer's anemia
B. Pellagra
C. Rachitis
D. Polyneuritis (beriberi)
E. Scurvy
257. 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 avitaminosis?
A. Glycosylation of hydroxylysine
residues
B. Hydroxylation of proline
C. Detaching of N-ended peptide
D. Formation of polypeptide chains
E. Removal of C-ended peptide from
procollagen
258. Examination of a man who
hadn't been consuming fats but had
been getting enough carbohydrates
and proteins for a long time revealed
dermatitis, poor wound healing, vision
impairment. What is the probable cause
of metabolic disorder?
A. Lack of oleic acid
 B. Lack of linoleic acid, vitamins A, A. A
D, E, K B. C
C. Lack of vitamins PP, H C. B1
D. Lack of palmitic acid D. K
E. Low caloric value of diet E. B2

259. A woman who has been 263. A patient consulted a doctor

keeping to a clean-rice diet for a long about symmetric dermatitis of open skin
time was diagnosed with polyneuritis areas. It was found out that the patient
(beriberi). What vitamin deficit results lived mostly on cereals and ate too little
in development of this disease? meat, milk and eggs. What vitamin
A. Folic acid deficiency is the most evident?
B. Riboflavin A. Calciferol
C. Pyridoxine B. Folic acid
D. Thiamine C. Nicotinamide
E. Ascorbic acid D. Biotin
E. Tocopherol
260. A patient underwent an
operation on account of gall bladder 264. A patient suffers from vision
excision that resulted in obstruction of impairment - hemeralopy (night
Ca absorption through the bowels blindness). What vitamin preparation
wall. What vitamin wil stimulate this should be administered the patient in
process? order to restore his vision?
A. D3 A. Pyridoxine
B. B12 B. Retinol acetate
C. K C. Vicasol
D. PP D. Thiamine chloride
E. C E. Tocopherol acetate

261. Surgical removal of a part of 265. A 3 year old child with

stomach resulted in disturbed symptoms of stomatitis, gingivitis and
absorption of vitamin B12, it is excreted dermatitis of open skin areas was
with feces. The patient was diagnosed delivered to a hospital. Examination
with anemi A. What factor is revealed inherited disturbance of
necessary for absorption of this neutral amino acid transporting in the
vitamin? bowels. These symptoms were caused
A. Pepsin by the deficiency of the following
B. Folic acid vitamin:
C. Hydrochloric acid A. Niacin
D. Gastrin B. Cobalamin
E. Gastromucoprotein C. Vitamin A
D. Biotin
262. As a result of posttranslative E. Pantothenic acid
modifications some proteins taking
part in blood coagulation, particularly 266. Increased breaking of vessels,
prothrombin, become capable of enamel and dentine destruction in
calcium binding. The following vitamin scurvy patients are caused by disorder
takes part in this process: of collagen maturing. What stage of

41
modification of procollagen is that vitamin B6 is a componet of the
disordered in this avitaminosis? following enzyme:
A. Hydroxylation of proline A. Netoglubarate dehydromine
B. Formation of polypeptide chains B. Pyruvate dehydrostase
C. Glycosylation of hydroxylysine C. Glutamate decarboxylase
residues D. Aminolevulinate synthase
D. Removal of C-ended peptide E. Glycogen phosphorylase
from procollagen
E. Detaching of N-ended peptide 16. Disorders of
267. A 10-year-old girl often Termoregulation. Fever.
experiences acute respiratory
infections with multiple spotty 271. What heat transfer mechanism
haemorrages in the places of clothes is the most effective while the man
friction. Hypovitaminosis of what being at 80% of air moisture and the
vitamin is present at the girl? temperature +350С?
A. В6 A. Radiation
B. В1 B. Heat conduction
C. А C. Convection
D. В2 D. Evaporation
E. С E. --

268. Vitamin A deficit results in the 272. A 50-year-old patient with

impairment of twilight vision. Name
the cells that have the above-
mentioned photoreceptor function:
A. Ganglion neurocytes
B. Horizontal neurocytes
C. Bipolar neurons
D. Cone receptor cells
E. Rod receptor cell
269. A sportsman was
recommended to take a medication
that contains carnitine in order to
improve his results. What process is
activated by carnitine the most?
A. Synthesis of steroid hormones
B. Tissue respiration
C. Synthesis of ketone bodies
D. Fatty acids transport to
mitochondrions
E. Synyhesis of lipids
270. A newborn child has
convulsions that have been observed
after prescription of vitamin B6. This
most probable cause of this effect is
typhoid fever was treated with
Levomycetin, the next day his condition
became worse, temperature rised to
39,60С. What caused worthening?
A. Secondary infection addition
B. Reinfection
C. The effect of endotoxin agent
D. Allergic reaction
E. Irresponsiveness of an agent to
the levomycetin
273. A patient in winter fall down into
ice-hole, froze and fall ill. The
temperature increased up to 39,70С
and ranged from 39,00C tо 39,80С .
Name the type of temperature curve of
this patient.
A. Febris recurrens
B. Febris continua
C. Febris intermittens
D. Febris remittens
E. Febris hectica
274. A patient experienced a sudden
temperature rise up to 390С. After 6

42
hours the temperature normalized. On C. Violation of heat loss through
the 2-nd day the attack recurred: in lungs
the period of paroxysm the D. Inflammatory barrier formation in
0
temperature reached 41 С, apyrexial injection place
period began after 8 hours. What type E. Violation of heat-producing
of temperature profile is it? mechanisms
A. Recurrent
B. Hectic 278. A lightly dressed man is
C. Septic standing in a room, air temperature is
D. Continued +14°C, windows and doors are closed.
E. Intermitting In what way does he emit heat the most
actively?
275. A patient who suffers from A. Heat radiation
pneumonia has high body temperatur B. Heat conduction
e. What biologically active substance C. Evaporation
plays the leading part in origin of this D. Perspiration
phenomenon? E. Convection
A. Interleukin-I
B. Bradykinin 279. A patient who had been
C. Histamine working hard under conditions of
D. Leukotrienes elevated temperature of the
E. Serotonin environment, has now a changed
quantity of blood plasma proteins. What
276. The patient has come to the phenomenon is the case?
hospital from the smelting workshop in A. Absolute hyperproteinemia
the condition of hyperthermia. What is B. Absolute hypoproteinemia
the direct cause of loss of C. Relative hyperproteinemia
consciousness at the heat stroke? D. Disproteinemia
A. Decreased brain blood supply E. Paraproteinemia
B. Arterial pressure drop
C. Increased water loss through 280. People adapted to high external
sweating temperatures have such pecularity:
D. Dilatation of peripheral vessels profuse sweating isn't accompanied by
E. Decrease of heart output loss of large volumes of sodium
chloride. This is caused by the effect of
277. A 52 year-old patient with the following hormone upon the
bronchial asthma was treated with perspiratory glands:
glucocorticoids. Fever reaction A. Aldosterone
appeared as a result of postinjective B. Natriuretic
abscess. The patient had subfebrile C. Cortisol
temperature, which didn’t correspond D. Tgyroxin
to latitude and severity of E. Vasopressin
inflammatory process. Why did patient
have low fever reaction? 281. A 25-year-old man has spent a
A. Inhibited endogen pyrogens long time in the sun under high air
production humidity. As a result of it his body
B. Thermoregulation center temperature rose up to 39oC. What
inhibition pathological process is it?

43
 A. Hyperthermia what acid substance to the blood can
B. Burn disease this state be explained?
C. Hypothermia A. Lactate
D. Infectious fever B. α-ketoglutarate
E. Noninfectious fever C. Pyruvate
D. 1,3-bisphosphoglycerate
282. Which way of heat emission E. 3-phosphoglycerate
by the bodies of greenhouse workers
is the most effective at the 286. If strong oxidizers get into the
temperature of 36oC degrees and bloodstream, a methemoglobin is
relative humidity of 70%? formed. It is a compound, where iron
A. Heat radiation (II) becomes iron (III). What has to be
B. Convection done to save the patient?
C. Thermal conduction A. He has to be given pure oxygen
D. Liquid evaporation B. He has to be calmed down and
E. - put to bed
C. Respiratory centers have to be
283. After transfusion of 200 ml of stimulated
blood a patient presented with body D. Interchangeable hemotransfusion
temperature rise up to 37,9oC. Which has to be done
of the following substances is the E. Patient has to be exposed to the
most likely cause of temperature rise? fresh air
A. Interleukin-1
B. Tumour necrosis factor 287. A 56 y.o. patient has been
C. Interleukin-2 suffering from thyreotoxicosis for a long
D. Interleukin-3 time. What type of hypoxia can be
E. Interleukin-4 developed?
A. Hemic
284. A patient has been diagnosed B. Respiratory
with influenza. His condition became C. Mixed
drastically worse after taking D. Tissue
antipyretic drugs. His consciousness E. Circulatory
is confused, AP is 80/50 mm Hg, Ps is
140/m, body temperature droped 288. There is a severe time
down to 35,8oC. What complication restriction for people's staying at a
developed in this patient? height of over 800 m above the sea
A. Alkalosis level without oxygen bombs. What is
B. Collapse the life limiting factor in this case?
C. Hyperthermia A. Partial oxygen pressure
D. Acidosis B. Moisture level
E. Hypovolemia C. Temperature
D. Earth gravity
17. Hypoxia E. Ultraviolet intensity

285. Buffer capacity of blood was 18. Disorders of

decreased in the worker due to Respiratory System
exhausting muscular work. Entry of

44
 289. Lung of premature infant is
presented on electronic
photomicrography of biopsy material.
Collapse of the alveolar wall caused
by the deficiency of surfactant was
revealed. Disfunction of what cells of
the alveolar wall caused it?
A. Fibroblasts
B. Alveolar macrophages
C. Secretory cells
D. Alveocytes type II
E. Alveocytes type I
290. Child asked you to puff up the
balloon as much as possible for a one
exhalation.What air volume will you
use?
A. Functional residual volume
B. Inspiration volume
C. Total volume of the lungs
D. Backup volume of the inspiration
E. Vital volume of the lungs
291. While having the dinner the
child choked and aspirated the food.
Meavy cough has started, skin and
mucose are cyanotic, rapid pulse, rear
breathing, expiration is prolonged.
What disorder of the external
breathing developed in the child?
A. Biot's breathing
B. Stage of expiratory dyspnea on
asphyxia
C. Alternating breathing
D. Stage of inspiratory dyspnea on
asphyxia
E. Stenotic breathing
292. A 62-year-old patient was
admitted to the neurological
department due to cerebral
haemorrage. Condition is grave.
There is observed progression of
deepness and frequency of breath
that turnes into reduction to
apnoea,and the cycle repeates. What
respiration type has developed in the
patient?
45
A. Apneustic respiration
B. Cheyne-Stockes respiration
C. Kussmaul respiration
D. Biot's respiration
E. Gasping respiration
293. A patient because of
pathological process has thickened
alveolar membrane. What will be
reduced directly as a result this?
A. Oxygen capacity of blood
B. Alveolar lung ventilation
C. Diffuse lung capacity
D. Reserve expiratiory capacity
E. Minute respiratory capacity
294. A woman with myasthenia
developed respiratory disorders, which
required artificial ventilation. What type
pf respiratory insufficiency did the
woman have?
A. Centrogenic
B. Restrictive
C. Neuromuscular
D. Thoracophrenic
E. Obstructive
295. A man in a quiet condition
has increased activity of the muscles,
responsible for the inspiration. What
from the belowmentioned can cause
this?
A. Infrequent breathing
B. Superficial breathing
C. Airways narrowing
D. Negative intrapleural pressure
E. Reduction of minute respiratory
capacity
296. During the examination of
blood gases a patient with chronic
respiratory diseases accompanied by
dyspnea, tachycardia and cyanosis
demonstrated the development of
hypoxemia and hypercapnia. What
disorder of the external respiration does
the patient have?
A. Hyperperfusion
 B. Hyperdiffusion
C. Hyperventilation
D. Hypoperfusion
E. Hypoventilation
297. Intrapleural pressure is being
measured in a person. In what phase
has a person hold his breath if the
pressure is - 25 cm H2O?
A. Speed up inspiration (Forced
inspiration )
B. Calm expiration
C. Calm inspiration
D. Speed up expiration
E. –
298. While having the dinner the
child choked and aspirated the food.
Heavy 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. Biot's respiration
B. Stenotic respiration
C. Stage of expiratory dyspnea on
asphyxia
D. Alternating respiration
E. Stage of inspiratory dyspnea on
asphyxia
299. A man's intrapleural pressure
is being measured. In what phase did
the man hold his breath, it his
pressure is 7.5 cm Hg?
A. Quiet expiration
B. Forced inspiration
C. Quiet inspiration
D. Forced expiration
E. –
300. A group of mountain climbers
went through the blood analysis at the
height of 3000 m. It revealed decrease
of HCO3 to 15 micromole/l (standard is
22-26 mmole/l). What is the
mechanism of HCO3, decrease?
A. Decrease of ammoniogenesis
46
B. Decrease of bicarbonate
reabsorption in kidneys
C. Hyperventilation
D. Intensification of acidogenesis
E. Hypoventilation
301. Spasm of smooth muscle of
bronchi developed in the patient. Usage
of activators of what membrane
cytoreceptors is fisiologically valid to
decrease attack?
A. alpha- and beta-аdrenoreceptors
B. Н-cholinoreceptors
C. Beta-adrenoreceptors
D. Alpha-аdrenoreceptors
E. М-cholinoreceptors
302. Child asked you to puff up the
balloon as much as possible for a one
exhalation.What air volume will you
use?
A. Vital volume of the lungs
B. Inspiration volume
C. Functional residual volume
D. Total volume of the lungs
E. Backup volume of the inspiration
303. The alveolar ventilation of the
patient is 5 L/min, the breath frequency
is 10 per/min, and the tidal volume is
700 ml. What is the patient's dead
space ventilation?
A. 0,7 L/min
B. 1,0 L/min
C. 2,0 L/min
B. 4,3 L/min
E. -
304. A patient after pathological
process has a thickened alveolar
membrane. The direct consequence of
the process will be the reduction of:
A. Reserve expiratiory capacity
B. Oxygen capacity of blood
C. Minute respiratory capacity
D. Alveolar lung ventilation
E. Diffuse lung capacity
 305. 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. Decreasing of alveoli receptors
sensitivity
C. Increased lungs elasticity
D. Inhibition of respiratory center
E. Excitation of respiratory center
306. 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 pure oxygene inhalation
B. By surfactant introduction
C. By glycose introduction
D. By artificial pulmonary
ventilation
E. By fluid suction from the
respiratory tracts
307. A patient has a transverse
disruption of spinal cord below the IV
thoracic segment. What changes of
respiration will it cause?
A. Respiration will stay unchanged
B. Respiration will become less
frequent
C. Respiration will become more
frequent
D. Respiration will become deeper
E. Respiration will stop
308. Examination of a miner
revealed pulmonary fibrosis
accompanied by disturbance of
alveolar ventilation. What is the main
mechanism of this disturbance?
A. Constriction of superior
respiratory tracts
B. Limitation of respiratory surface
of lungs
C. Disturbance of neural respiration
control
D. Bronchi spasm
E. Limitation of breast mobility
47
309. A 12 y.o. boy who suffers from
bronchial asthma has an acute attack
of asthma: evident expiratory dyspnea,
skin pallor. What type of alveolar
ventilation disturbance is it?
A. Throracodiaphragmatic
B. Central
C. Obstructive
D. Restrictive
E. Neuromuscular
310. Lungs of a preterm infant have
areas of atelectasis (pulmonary
collapse). The main cause is:
A. Underdeveloped inspiration
muscles
B. Diminished force of surface
tension of lungs
C. Increased viscous resistance
D. Surfactant excess
E. Surfactant deficiency
311. An unconscious young man
with signs of morphine poisoning
entered admission office. His
respiration is shallow and infrequent
which is caused by inhibition of
respiratory centre. What type of
respiratory failure is it?
A. Perfusive
B. Ventilative restrictive
C. Diffusive
D. Ventilative obstructive
E. Ventilative dysregulatory
312. A young woman who entered a
production department where it strongly
smelt of paints and varnishes had a
bronchospasm. This reflex was caused
by irritation of the following receptors:
A. Central chemoreceptors
B. Peripheral chemoreceptors
C. Pleura receptors
D. Irritant
E. Juxtaglomerular
 313. Voluntary breath-holding
caused increase of respiration depth
and frequency. The main factor
stimulating these changes of external
respiration is:
A. Increased tension of CO2 in
blood
B. Decreased tension of O2 in
blood
C. Decreased concentration of H+
in blood
D. Increased tension of O2 in blood
E. Decreased tension of CO2 in
blood
314. A patient staying in the
pulmonological department was
diagnosed with pulmonary
emphysema accompanied by reduced
elasticity of pulmonary tissue. What
type of respiration is observed?
A. Inspiratory dyspnea
B. Periodic respiration
C. Superficial respiration
D. Infrequent respiration
E. Expiratory dyspnea
315. A patient with marked
pneumofibrosis that developed after
infiltrating pulmonary tuberculosis has
been diagnosed with respiratory
failure. What is its pathogenetic type?
A. Dysregulatory
B. Obstructive
C. Reflex
D. Apneistic
E. Restrictive
316. Lung ventilation in a person is
increased as a result of physical
activity. Which of the following indices
of the external respiration is much
higher than in a state of rest?
A. Respiratory volume
B. Expiratory reserve volume
C. Vital capacity of lungs
D. Inspiratory reserve volume
E. Total lung capacity
48
19. Disorders of Blood.
RBC Related Pathology
317. A 32-year-old patient was
admitted to the hospital with gross
bloodloss due to auto accident trauma.
Ps – 110 Bpm, RR - 22 pm, BP-
100/60mm Hg. What changes in the
blood will occur in an hour after the
bloodloss?
A. Hypovolemia
B. Hypoproteinemia
C. Hypochromia of erythrocytes
D. Leukopenia
E. Erythropenia
318. Blood sampling for bulk
analysis is recommended to be
performed on an empty stomack and in
the morning. What changes in blood
count can occur if to perform blood
sampling after food intake?
A. Increased plasma proteins
B. Increased contents of leukocytes
C. Increased contents of
erythrocytes
D. Reduced contents of
thrombocytes
E. Reduced contents of erythrocytes
319. In the blood of a 26-year-old
man it was revealed 18% of
erythrocytes of the spherical, ball-
shaped, flat and thorn-like shape. Other
eritrocytes were in the form of the
concavo-concave disks. How is such
phenomenon called?
A. Pathological poikilocytosis
B. Physiological anisocytosis
C. Pathological anisocytosis
D. Erytrocytosis
E. Physiological poikilocytosis
320. In the microspecimen of red
bone marrow there were revealed
multiple capillares through the walls of
which mature blood cells penetrated. 324. A denaturation of proteins can
What type of capillares is it? be found in some substances. Specify
A. Sinusoidal the substance that is used for the
B. Fenestrational incomplete denaturation of hemoglobin:
C. Somatical A. Sulfuric acid
D. Visceral B. Nitric acid
E. Lymphatic C. Toluene
D. Sodium hydroxide
321. A 38-year-old woman was E. Urea
admitted to the admission-diagnostic
department with uterine bleeding. 325. Examination of a pregnant
What are the most likely changes of woman revealed twice as much
blood? concentration of fibrinogen in blood
A. Increase of haematocrite rate plasm. What ESR can this woman
B. Leukopenia have?
C. Leucocytosis A. 0-5 mm/h
D. Polycythemia B. 5-10 mm/h
E. Reduction of haematocrite rate C. 2-12 mm/h
D. 40-50 mm/h
322. On blood grouping on the E. 10-15 mm/h
system ABO, standart serum of the I
and II groups caused erythrocytes 326. Blood count of an athlete is as
agglutination of the examined blood follows: erythrocytes - 5,5*1012/l, Hb-
and serum group of the III didn't. What 180 g/l, leukocytes – 7*109/l,
agglutinogens are in this neutrophils - 64%, basophils - 0,5%,
erythrocytes? eosinophils - 0,5%, monocytes - 8%,
A. А and В lymphocytes - 27%. First of all, such
B. С results indicate the stimulation of:
C. В A. Leukopoiesis
D. А B. Lymphopoiesis
E. D and C C. Immunogenesis
D. Erythropoiesis
323. If strong oxidizers get into the E. Granulocytopoiesis
bloodstream, a methemoglobin is
formed. It is a compound, where iron 327. Patient with hypochromic
(II) becomes iron (III). What has to be anemia has splitting hair and loss of
done to save the patient? hair, increased nail brittling and taste
A. He has to be given pure oxygen alteration. What is the mechanism of
B. He has to be calmed down and the development of these symptoms?
put to bed A. Decreased production of
C. Respiratory centers have to be parathyrin
stimulated B. Decreased production of thyroid
D. Interchangeable hormones
hemotransfusion has to be done C. Deficiency of vitamin В12
E. Patient has to be exposed to the D. Deficiency of vitamin А
fresh air E. Deficiency of iron-containing
enzymes

49
 328. Substitution of the glutamic A. FADH2
acid on valine was revealed while B. FMNH2
examining initial molecular structure. C. Pyridoxalphosphate
For what inherited pathology is this D. Ubiquinone
typical? E. NADPH
A. Minkowsky-Shauffard disease
B. Hemoglobinosis 332. Patient 54 year-old, 5th day
C. Sickle-cell anemia after surgical operation. Blood count:
D. Favism Erythrocytes 3,6*1012/l, Hemoglobin 95
E. Thalassemia g/l, Erythrocyte’s hemoglobin content
(color index) 0,78; Leukocytes 16*109/l,
329. A 58-year-old woman Platelets 450*109/l Blood picture:
complaints of increased tiredness, anizocytosis, poikilocytosis,
decreased capasity for work, reticulocytes- 3,8%. What anemia does
somnolence and dyspnea during fast this patient have?
walking. Blood test revealed: A. Chronic posthemorragic anemia
12
erythrocytes - 4,6*10 /l, hemoglobin - B. Acquired hemolytic anemia
92 g/l, colour index - 0,6. Blood smear C. Acute posthemorragic anemia
demonstrated high contents of D. Anemia from iron deficiency
microcytes and anulocytes. What E. Hypoplastic anemia
anemia is it typical for?
A. Acute posthemorrhagic 333. In the blood of a 26-year-old
B. Hemolytic man 18% of erythrocytes of the
C. Iron deficiency spherical, ball-shaped, flat and thorn-
D. Penicious like shape have been revealed. Other
E. Sickle cell eritrocytes were in the form of the
concavo-concave disks. How is this
330. A 43-year-old man suffers phenomenon called?
from chronic atrophic gastritis and A. Physiological poikilocytosis
megaloblastic hyperchromic anemia. B. Erytrocytosis
He also has methylmalonic aciduria. C. Pathological poikilocytosis
Insufficiency of what vitamin led to the D. Physiological anisocytosis
development of such complex of E. Pathological anisocytosis
symptoms?
A. Vitamin В3 334. A patient's blood was analyzed
B. Vitamin В12 and the decreased erythrocyte’s
C. Vitamin В2 sedimentation rate (ESR) was
D. Vitamin В1 discovered. What disease from the
E. Vitamin В5 listed below is accompanied with
decreased ESR?
331. A 38-year-old patient after A. Myocardial infarction
taking aspirin and sulphanilamides B. Hepatitis
has profound hemolysis of C. Splenomegaly
erythrocytes, which is caused by D. Polycytemia
glucose 6-phosphate dehydrogenase E. Vitamin B deficiency
insufficiency. The disorder of
formation of what coenzyme causes 335. A 7-year-old girl has signs of
this pathology? anemia. Laboratory examination

50
revealed pyruvate kinase deficiency in
erythrocytes. What process
disturbance plays the main role in
anemia development?
A. Anaerobic glycolysis
B. Tissue respiration
C. Oxidative phosphorylation
D. Aminoacids desamination
E. Peroxide decomposition
336. A 38-year-old woman was
admitted to the admission-diagnostic
department with uterine bleeding.
What are the most likely changes of
blood?
A. Reduction of haematocrite rate
B. Increase of haematocrite rate
C. Leucocytosis
D. Leukopenia
E. Polycythemia
337. Examination of a 43 y.o.
anephric patient revealed anemia
symptoms. What is the cause of these
symptoms?
A. Folic acid deficit
B. Vitamin B12 deficit
C. Reduced synthesis of
erythropoietins
D. Enhanced destruction of
erythrocytes
E. Iron deficit
338. In some regions of South
Africa there is a spread sickle-shaped
cell anemia, in which erythrocytes
have shape of a sickle as a result of
substitution of glutamin by valine in
the hemoglobin molecul e. What is the
cause of this disease?
A. Gene mutation
B. Disturbance of mechanisms of
genetic information realization
C. Genomic mutations
D. Crossingover
E. Transduction
51
339. 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. Iron-deficient
B. Hemolytic
C. Aplastic
D. B12-folate deficient
E. Posthemorrhagic
340. 2 years ago a patient
underwent resection of pyloric part of
stomach. He complains of weakness,
periodical dark shadows beneath his
eyes, dyspne A. In blood: Hb - 70 g/l,
erythrocytes - 3,0*1012/l, colour index -
0,7. What changes of erythrocytes in
blood smears are the most typical for
this condition?
A. Megalocytes
B. Ovalocytes
C. Schizocytes
D. Macrocytes
E. Microcytes
341. A 20 year old patient complains
of general weakness, dizziness, quick
fatigability. Blood analysis results: Hb-
80 g/l. Microscopical examination
results: erythrocytes are of modified
form. This condition might be caused
by:
A. Obturative jaundice
B. Addison's disease
C. Hepatocellular jaundice
D. Acute intermittent porphyria
E. Sickle-cell anemia
342. A 55 y.o. woman consulted a
doctor about having continuous cyclic
uterine hemorrhages for a year,
weakness, dizziness. Examination
revealed skin pallor. Hemogram: Hb –
70 g/l, erythrocytes - 3.2 1012/l, color
index - 0.6, leukocytes – 6.0 109/I,
reticulocytes - 1%; erythrocyte
hypochromia. What anemia is it?
A. B12-folate-deficiency anemia
B. Aplastic anemia
C. Iron-deficiency anemia
D. Chronic posthemorrhagic
anemia
E. Hemolytic anemia
343. A woman with III (B), Rh–
blood group born a child with II (A)
blood group. The child is diagnosed
with hemolytic disease of newborn as
a result of rhesus incompatibility.
What blood group is the child's father
likely to have?
A. II (A), Rh+
B. II (A), Rh-
C. (0), Rh+
D. Ill (B), Rh+
E. I (0), Rh-
344. A 25 year old Palestinian
woman complains of weakness,
dizziness, dyspne A. In anamnesis:
periodically exacerbating anemi A. In
blood: Hb - 60 g/l, erythrocytes -
2,5*1012/l, reticulocytes - 35‰,
anisocytosis and poikilocytosis of
erythrocytes, a lot of target cells and
polychromatophils. What type of
anemia is it?
A. Sickle-cell anemia
B. Addison-Biermer disease
C. Glucose 6-phosphate
dehydrogenase-deficient anemia
D. Minkowsky-Shauffard disease
E. Thalassemia
345. A 34 year old woman was
diagnosed with hereditary
microspherocytic hemolytic anemia
(Minkowsky-Shauffard disease). What
mechanism caused haemolysis of
erythrocytes?
A. Autoimmune disorder
B. Bone marrow hypoploasia
52
C. Enzymopathy
D. Membranopathy
E. Hemoglobinopathy
20. Disorders of Blood.
WBC Related Pathology
346. On microscopic examination of
the enlarged neck gland of a 14-year-
old girl it was 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,
eosinophiles, atypical cells of the large
size with multiple-lobule nuclei
(Beresovsky-Shternberg cells) and
onenucleus cells of the large size are
present. What is the most likely
diagnosis?
A. Fungous mycosis
B. Chronic lympholeucosis
C. Lymphogranulomatous
D. Berkitt's lymphoma
E. Acute lympholeucosis
347. A patient with acute
myeloblast leucosis has developed liver
and spleen enlargement, anemia,
myeloblasts in peripheral blood. What
principal sign allows to differ myeloblast
leukosis from chronic one?
A. Leukemic collapse
B. Pancytopenia
C. Anemia
D. Blast cells in peripheral blood
E. Thrombocytopenia
348. 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. Basophils
B. Eosinophils
C. Monocytes
D. Neutrophils
E. Limphocytes
349. In the blood of a 26-year-old
man 18% of erythrocytes of the
spherical, ball-shaped, flat and thorn-
like shape have been revealed. Other
erythrocytes were in the form of the
concavo-concave disks. How is this
phenomenon called?
A. Physiological poikilocytosis
B. Erytrocytosis
C. Pathological poikilocytosis
D. Physiological anisocytosis
E. Pathological anisocytosis
350. 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. Reduced contents of
erythrocytes
B. Increased contents of
erythrocytes
C. Increased contents of
leukocytes
D. Increased plasma proteins
E. Reduced contents of
thrombocytes
351. A patient operated on
complicated appendicitis has the
following changes of blood count:
erythrocytes - 4,0.1012/l, Нb - 120 g/l,
color index - 0,9, leukocytes –
18.109/l, basophils - 0, eosinophils - 0,
myelocytes - 0, juvenile - 0, stab
neutrophils - 20, segmentonuclear
neutrophils - 53, lymphocytes - 21,
monocytes - 5. How is such nuclear
shift of leukocytic formula called?
A. Hyperregenerative
B. Regeneratively-degenerative
53
C. Regenerative left shift
D. Right shift
E. Degenerative left shift
352. 24 hours after appendectomy
blood of a patient presents neutrophilic
leukocytosis with regenerative shift.
What is the most probable mechanism
of leukocytosis development?
A. Amplification of leukopoiesis and
decelerated emigration of leukocytes to
the tissues
B. Decelerated leukocyte destruction
C. Deceleratied emigration of
leukocytes to the tissues
D. Amplification of leukopoiesis
E. Redistribution of leukocytes in the
organism
353. A 23 y.o. patient complains of
weakness, temperature rise up to 38-
400C. Objectively: liver and spleen are
enlarge d. 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 negativ
e. Make a hematological conclusion:
A. Acute erythromyelosis
B. Acute myeloblastic leukosis
C. Chronic myeloleukosis
D. Undifferentiated leukosis
E. Acute lymphoblastic leukosis
354. Two hours after an exam a
student had a blood count done and it
was revealed that he had leukocytosis
without significant leukogram
modifications. What is the most
probable mechanism of leukocytosis
development?
A. Deceleration of leukocyte
migration to the tissues
B. Deceleration of leukocyte lysis
C. Leukopoiesis intensification and
deceleration of leukocyte lysis
D. Leukopoiesis intensification
 E. Redistribution of leukocytes in
the organism
355. Parents of a 3 year old child
have been giving him antibiotics with
purpose of preventing enteric
infections for a long time. A month
later the child's condition changed for
the worse. Blood examination
revealed apparent leukopenia and
granulocytopenia. What is the most
probable mechanism of blood
changes?
A. Myelotoxic
B. Age-specific
C. Redistributive
D. Autoimmune
E. Hemolytic
356. A patient has a cluster of
matted together dense lymph nodes
on his neck. Histological examination
of a removed lymph node revealed
proliferation of reticular cells,
presense of Reed-Sternberg cells.
What disease is meant?
A. Lymphogranulomatosis
B. Myeloblastic leukosis
C. Lymphocytic leukosis
D. Lymphoblastic leukosis
E. Myelocytic leukosis
357. 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. Lysis of leukocytes in the blood-
forming organs
D. Intensified elimination of
leukocytes from the organism
E. Disturbed going out of mature
leukocytes from the marrow into the
blood
54
358. Having helped to eliminate
consequences of a failure at a nuclear
power plant, a worker got an irradiation
doze of 500 roentgen. He complains of
headache, nausea, dizziness. What
changes in leukocytes quantity can be
expected 10 hours after irradiation?
A. Lymphocytosis
B. Neutrophilic leukocytosis
C. Leukopenia
D. Leukemia
E. Agranulocytosis
359. 24 hours after appendectomy
blood of a patient presents neutrophilic
leukocytosis with regenerative shift.
What is the most probable mechanism
of leukocytosis development?
A. Deceleratied emigration of
leukocytes to the tissues
B. Amplification of leukopoiesis
C. Redistribution of leukocytes in the
organism
D. Amplification of leukopoiesis and
decelerated emigration of leukocytes to
the tissues
E. Decelerated leukocyte destruction
360. A 47 year old man with
myocardium infarction was admitted to
the cardiological department. What
changes of cellular composition of
peripheral blood are induced by
necrotic changes in the myocardium?
A. Monocytosis
B. Eosinophilic leukocytosis
C. Neutrophilic leukocytosis
D. Lymphopenia
E. Thrombocytopenia
361. 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 neutrophils - 0, band
neutrophils - 2, segmented neutrophils -
41, lymphocytes - 28, monocytes - 28. D. Hageman's factor
Name this phenomenon: E. Rosental's factor
A. Lymphocytosis
B. Agranulocytosis 365. A 2-year-old child has got
C. Eosinopenia intestinal dysbacteriosis, which results
D. Monocytosis in hemorrhagic syndrome. What is the
E. Neutropenia most likely cause of hemorrhage of this
child?
21. Disorders of A. Vitamin К insufficiency
B. Hypocalcemia
Hemostasis C. РР hypovitaminosis
D. Fibrinogen deficiency
362. A 43-year-old patient has E. Activation of tissue
thrombopenia, reduction of thromboplastin
fibrinogen, products of degradation of
fibrin presented in the blood, petechial 366. A patient with liver disease
haemorrhage along with septic shock. revealed the decreasing of prothrombin
What is the most likely cause of the level in the blood. It can, first of all,
changes? result in the impairment of:
A. Autoimmune thrombocytopenia A. The first phase of the coagulatory
B. DIC-syndrom hemostasis
C. Exogenous intoxication B. The second phase of the
D. Disorder of thrombocytes coagulatory hemostasis
production C. Vascular-thrombocytic
E. Haemorrhagic diathesis hemostasis
D. Anticoagulative properties of the
363. Punctata hemorrhage was blood
found out in the patient after E. Fibrinolysis
application of a tourniquet. With
disfunction of what blood cells is it 367. There is an inhibited
connected? coagulation in the patients with bile
A. Eosinophiles ducts obstruction, bleeding due to the
B. Lymphocytes low level of absorbtion of a vitamin.
C. Monocytes What vitamin is in deficiency?
D. Neutrophiles A. К
E. Platelets B. Е
C. D
364. A 6-months-old baby has D. А
got frequent and extensive subdermal E. Carotene
hemorrhages. The administration of
the synthetic analogue of vitamin K 368. Punctata hemorrhage was
(vicasol) was effective. γ-carboxylation found out in the patient after application
of glutamic acid of what protein of of a tourniquet. With disfunction of what
blood coagulation system does this blood cells is it connected?
vitamin take part in? A. Monocytes
A. Antihemophilic globulin A B. Eosinophiles
B. Fibrinogen C. Neutrophiles
C. Prothrombin D. Lymphocytes

55
 E. Platelets D. Vitamin E
E. Vitamin C
369. A couple came for medical
genetic counseling. The man has 373. As a result of posttranslative
hemophilia, the woman is healthy and modifications some proteins taking part
there were no cases of hemophilia in in blood coagulation, particularly
her family. What is the risk of having a prothrombin, become capable of
sick child in this family? calcium binding. The following vitamin
A. 25% takes part in this process:
B. 0 A. A
C. 100% B. C
D. 75% C. B1
E. 50% D. K
E. B2
370. A patient with tissue trauma
was taken a blood sample for the 374. A 16 year old boy after an
determination of blood clotting illness has diminished function of
parameters. Specify the right protein synthesis in liver as a result of
sequence of extrinsic pathway vitamin K deficiency. It will cause
activation. disturbance of:
A. III – VIII: TF – Xa A. Erythropoietin secretion
B. III – VIIa – Xa B. Osmotic blood pressure
C. III – IV – Xa C. Blood coagulation
D. IV – VIII: TF – Xa D. Anticoagulant generation
E. IV – VIIa – Xa E. Erythrocyte sedimentation rate

371. A patient was ill with burn 375. A clinic observes a 49 year old
disease that was complicated by DIC patient with significant prolongation of
syndrom e. What stage of DIC coagulation time, gastrointestinal
syndrome can be suspected if it is haemorrhages, subcutaneous
known that the patient's blood hematomas. These symptoms might be
coagulates in less than 3 minutes? explained by the deficiency of the
A. Hypercoagulation following vitamin:
B. Transition phase A. E
C. Fibrinolysis B. H
D. Terminal C. B6
E. Hypocoagulation D. B1
E. K
372. Examination of a patient with
frequent hemorrhages from internals 376. A tooth extraction in a patient
and mucous membranes revealed with chronic persistent hepatitis was
proline and lysine being a part of complicated with prolonged
collagen fibers. What vitamin absence hemorrhage. What is the reason for the
caused disturbance of their haemorrhagic syndrome?
hydroxylation? A. Decrease in thrombin production
A. Vitamin A B. Fibrinolysis intensification
B. Thiamine C. Increase in thromboplastin
C. Vitamin K production

56
 D. Increase in fibrinogen synthesis 380. In a 45-year-old patient on ECG
E. Decrease in fibrin production it was revealed: sinus rhythm, the
number of auricular complexesexceeds
377. A 10-year-old girl has a history number of ventricular complexes;
of repeated acute respiratory viral progressing extension of the P-Q
infection. After recovering she interval from complex to complex;
presents with multiple petechial fallout of some ventricular complexes;
hemorrhages on the sites of friction Р waves and QRST complexes are
from clothing rubbing the skin. What without changes. Name the type of
kind of hypovitaminosis has this girl? heart rhythm disfunction.
A. B2 A. Complete atrioventricular block
B. B1 B. Atrioventricular block of the II
C. C degree
D. B6 C. Atrioventricular blockade of the I
E. A degree
D. Synoauricular block
22. Disorders of E. Intraatrial block

Cardiovascular System 381. While emotional excitement the

378. Processes of repolarisation
are disturbed in ventricular
myocardium in examined person. It
will cause amplitude abnormalities of
configuration and duration of the
wave:
A. R
B. P
C. Q
D. S
E. Т
379. The patient with acute
miocardial infarction was given
intravenously different solutions during
8 hours with medical dropper 1500ml
and oxygen intranasally. He died
because of pulmonary edema. What
caused the pulmonary edema?
A. Inhalation of the oxygen
B. Decreased oncotic pressure due
to hemodilution
C. Neurogenic reaction
D. Allergic reaction
E. Volume overload of the left
ventricular
heart rate in a 30-year-old person run
up to 112 Bpm. What part of the
conducting system of the heart caused
it?
A. Intraventricular node
B. Synoatrial node
C. His bundle branches
D. His bundle
E. Purkinje's fibers
382. Dystrophic changes of the heart
muscle are accompanied with cardiac
cavity enlargement, decrease of the
strength of heart contraction, increased
amount of blood, which remains in the
heart during systolic phase, overfilled
veins. For what state of heart is it
characteristic?
A. Tonogenic dilatation
B. Emergency stage of
hyperfunction and hypertrophy
C. Myogenic dilatation
D. Cardiosclerosis
E. Tamponage of the heart
383. Transmural myocardial
infarction in the patient was
complicated with progressive acute left

57
ventricle insufficiency. What is the
most typical for this state?
A. Edema of the extremities
B. Cyanosis
C. Edema of the lungs
D. Arterial hypertension
E. Ascites
384. A 48-year-old patient after
severe psychoemotional exertion
suddenly began feeling sharp pain in
the heart region, irradiating into left
arm. Nitroglycerin releaved pain 10
minutes later. What pathogenetic
mechanism is responsible for the
development of pain in this case?
A. Compression of coronary
vessels
B. Spasm of coronary vessels
C. Dilation of peripheral vessels
D. Occlusion of coronary vessels
E. Increase of myocardial needs in
oxygen
385. 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 force of the
contraction
B. Decreased heart beat rate
C. Decreased rate and force of
heart beat
D. Heart stops in diastole
E. Heart stops in systole
386. 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. Vessels ' thrombosis
C. Secondary infection
D. Ischemia of myocardium
58
E. Resorption of enzymes from
necrotized area of myocardium
387. The high level of Lactate
Dehydrogenase (LDH) isozymes
concentration showed the increase of
LDH-1 and LDH-2 in a patient’s blood
plasma. Point out the most probable
diagnosis:
A. Diabetes mellitus
B. Skeletal muscle dystrophy
C. Viral hepatitis
D. Myocardial infarction
E. Acute pancreatitis
388. 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 a conductivity in the
right auricle
B. Violation of the automatism of a
atrio-ventricular node
C. Block of a conductivity in the
atrio-ventricular node
D. Arrhythmia
E. Violation of the automatism of a
Kiss-Fleck node
389. Dystrophic alterations of heart
are accompanied with dilation of heart
cavities, decreased force of heart
contractions, increased blood volume
that remains during systole in the heart
cavity, vein overfill. What heart
condition is it typical for?
A. Emergency stage of
hyperfunction and hypertrophy
B. Cardiosclerosis
C. Myogenic dilatation
D. Tonogenic dilatation
E. Cardiac tamponade
390. A patient who suffers from
severe disorder of water-salt
metabolism experienced cardiac arrest
in diastole. What is the most probable
mechanism of cardiac arrest
diastole?
A. Hypokaliemia
B. Hypernatremia
C. Hyperkaliemia
D. Hyponatremia
E. Organism dehydratation
391. 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 atrium
C. Right ventricle
D. Left atrium
E. –
392. ECG of a patient with
hyperfunction of thyroid gland showed
heart hurry. It is indicated by
depression of the following ECG
element:
A. QRS complex
B. P-T interval
C. P-Q interval
D. R-R interval
E. P-Q segment
393. A patient ill with essential
arterial hypertension had
hypertensic crisis that resulted in an
attack of cardiac asthma. What is the
leading mechanism of cardiac
insufficiency in this case?
A. Blood supply disturbance
B. Heart overload caused by high
pressure
C. Heart overload caused by
increased blood volume
D. Myocardium damage
E. Absolute coronary insufficiency
394. A 59 year old patient is a plant
manager. After the tax inspection of
his plant he felt intense pain behind
in his breastbone irradiating to his left
arm. 15 minutes later his condition
came to normal. Which of the possible
mechanisms of stenocardia
development is the leading in this
case?
A. Functional heart overload
B. High catecholamine concentration
in blood
C. Intravascular aggregation of
blood corpuscles
D. Coronary thrombosis
E. Coronary atherosclerosis
395. In course of a preventive
examination of a miner a doctor
revealed changes of cardiovascular
fitness which was indicative of cardiac
insufficiency at the compensation
stage. What is the main proof of cardiac
compensation?
A. Cyanosis
B. Myocardium hypertrophy
C. Dyspnea
D. Tachycardia
E. Rise of arterial pressure
396. Person has stable HR, not
more than 40 bpm. What is the
pacemaker of the heart rhythm in this
person?
A. His' bundle
a B. Branches of His' bundle
C. Purkinye' fibers
D. Atrioventricular node
E. Sinoatrial node
397. On examination of the person it
was revealed that minute volume of
heart is 3500mL, 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
59
 398. The process of heart
transplantation determined the viability
of myocardial cells. The determination
of what myocardium parameter is the
most important?
A. Concentration of Ca-ions in
heart vessels
B. Heart temperature
C. Concentration of calcium-ions in
myofibrils
D. Concentration of oxygen in heart
vessels
E. Rest potential of cardiomyocytes
399. Extensive thromboembolic
infarction 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. Septicemia
B. Acute rheumatic valvulitis
C. Septicopyemia
D. Rheumatic thromboendocarditis
E. Septic bacterial endocarditis
400. On experiment on the dog the
peripheral part of nervus vagus of the
neck was irritated. What changes of
the heart function would be observed?
A. Increased atrioventricular
conduction
B. Increased contraction force and
rate
C. Decreased contraction rate
D. Increased contraction force
E. Increased myocardial excitability
401. Marked increase of activity of
МВ-forms of CPK
(creatinephosphokinase) and LDH-1
were revealed on the examination of
60
the patient's blood. What is the most
likely pathology?
A. Rheumatism
B. Pancreatitis
C. Cholecystitis
D. Miocardial infarction
E. Hepatitis
401. 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 liver and kidneys
E. In connective tissue
402. A peripheral segment of vagus
nerve on a dogs neck was being
stimulated in course of an experiment.
The following changes of cardiac
activity could be meanwhile observed:
A. Heart rate fall
B. Increased excitability of
myocardium
C. Heart hurry
D. Heart rate and heart force
amplification
E. Enhancement of atrioventricular
conduction
403. A patient who suffers from
acute myocarditis has clinical signs of
cardiogenic shock. What of the under-
mentioned pathogenetic mechanisms
plays the main part in shock
development?
A. Reduction of diastolic flow to the
heart
B. Increase of peripheral vascular
resistance
C. Depositing of blood in organs
 D. Disturbance of pumping ability of caused by deceleration in ventricles of:
heart A. Depolarization and repolarization
E. Decrease of vascular tone B. Contraction
C. Depolarization
404. A 49 y.o. woman consulted a D. Relaxation
doctor about heightened fatigue and E. Repolarization
dyspnea during physical activity. ECG:
heart rate is 50/min, PQ is extended, 408. Vagus branches that innervate
QRS is unchanged, P wave quanity heart are being stimulated during an
exceeds quantity of QRS complexes. experiment. This caused reduction of
What type of arrhythmia does the heart rate due to the intensification of
patient have? the following process (through the cell
A. Extrasystole membrane of cardiac pacemaker):
B. Ciliary arhythmia A. Calcium ion yield
C. Sinus bradycardia B. Calcium and potassium ion yield
D. Atrioventricular block C. Calcium ion entry
E. Sinoatrial block D. Potassium ion entry
E. Potassium ion yield
405. A patient suffering from
stenocardia was taking nitroglycerine 409. An isolated cell of human heart
which caused restoration of blood automatically generates excitement
supply of myocardium and relieved impulses with frequency of 60 times per
pain in the cardiac area. What minute. This cell was taken from the
intracellular mechanism provides following heart structure:
restoration of energy supply of A. Atrioventricular node
insulted cells? B. Atrium
A. Intensification of RNA C. Ventricle
generation D. Sinoatrial node
B. Intensification of ATP E. His' bundle
resynthesis
C. Intensification of oxygen 410. A 45 year old patient was
transporting into the cell admitted to the cardiological
D. Increased permeability of department. ECG data: negative P
membranes wave overlaps QRS complex, diastolic
E. Reduction of ATP resynthesis interval is prolonged after extrasystole.
What type of extrasystole is it?
406. A patient has delayed A. Ventricular
conduction of excitement through the B. Atrial
atrioventricular node. What changes C. Atrioventricular
of ECG will be observed? D. Sinus
A. Prolongation of Q-T interval E. Bundle-branch
B. S-T-segment displacement
C. Prolongation of P-Q interval 411. A 63 year old male patient who
D. Negative T wave had been suffering from chronic diffuse
E. Prolongation of Q-S interval obstructive disease, pulmonary
emphysema, for 15 years died from
407. ECG of a patient shows cardiac insufficiency. Autopsy revealed
prolongation of T-wav E. This is nutmeg liver cirrhosis, cyanotic

61
induration of kidneys and spleen,
ascites, edemata of lower limbs.
These changes of internal organs are
typical for the following disease:
A. General cardiac insufficiency
B. Acute left-ventricular
insufficiency
C. Acute right-ventricular
insufficiency
D. Chronic right-ventricular
insufficiency
E. Chronic left-ventricular
insufficiency
412. 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. Purkinje's fibers
B. Sinoatrial node
C. His' bundle branches
D. Atrioventricular node
E. His' bundle
413. 12 hours after an accute
attack of retrosternal pain a patient
presented a jump of aspartate
aminotransferase activity in blood
serum. What pathology is this
deviation typical for?
A. Myocardium infarction
B. Diabetes insipidus
C. Collagenosis
D. Diabetes mellitus
E. Viral hepatitis
414. ECG of a 44-year-old patient
shows signs of hypertrophy of both
ventricles and the right atrium. The
patient was diagnosed with the
tricuspid valve insufficiency. What
pathogenetic variant of cardiac
dysfunction is usually observed in
case of such insufficiency?
A. Heart overload by volume
B. Coronary insufficiency
62
C. Heart overload by resistance
D. Primary myocardial insufficiency
E. Cardiac tamponade
415. 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?
A. Accumulation of Na+ and Ca2+
ions in the myocardium cells
B. Reduction of Na+ and Ca2+ ions in
the myocardium cells
C. Reduction of K+ and Mg2+ ions in
the extracellular space
D. Accumulation of K+ and Mg2+ ions
in the myocardium cells
E. Reduction of Na+ and Ca2+ ions in
the extracellular space
416. The minute blood volume in a
patient with transplanted heart has
increased as a result of physical
activity. What regulative mechanism is
responsible for these changes?
A. Sympathetic conditioned reflexes
B. Parasympathetic conditioned
reflexes
C. Sympathetic unconditioned
reflexes
D. Catecholamines
E. Parasympathetic unconditioned
reflexes
417. In response to a change in
body position from horizontal to vertical
blood circulation system develops
reflectory pressor reaction. Which of
the following is its compulsory
component?
A. Weakening of the pumbing ability
of heart
B. Decrease in the circulating blood
volume
C. Increase in the heart rate
D. Systemic dilatation of the arterial
resistive vessels
 E. Systemic constriction of the
venous vessels
418. During fighting a man had a
cardiac arrest as a result of a hard
blow to the upper region of anterior
abdominal wall. Which of the
described mechanisms might have
provoked the cardiac arrest?
A. Sympathetic unconditioned
reflexes
B. Peripheric reflexes
C. Sympathetic conditioned
reflexes
D. Parasympathetic unconditioned
reflexes
E. Parasympathetic conditioned
reflexes
419. 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?
A. Increase in and
adrenoreceptors quantity
B. Mg2+ loss by cardiac hystiocytes
C. Damage of specific membrane
pumps
D. Cardiac hystiocyte dehydration
E. Ca2+ loss by cardiac hystiocytes
420. Arterial hypertention is caused
by the stenosis of the renal arteries in
the patient. Activation of what system
is the main link in the pathogenesys of
this form of hypertension?
A. Parasympathetic
B. Kallikrein-kinin
C. Renin-angiotensin
D. Sympathoadrenal
E. Hypothalamic-pituitary
421. A patient ill with essential
arterial hypertension had a D. Functions of adrenal cortex
hypertensic crisis that resulted in an
63
attack of cardiac asthma. What is the
leading mechanism of cardiac
insufficiency in this case?
A. Blood supply disturbance
B. Heart overload caused by high
pressure
C. Heart overload caused by
increased blood volume
D. Myocardium damage
E. Absolute coronary insufficiency
422. Arterial pressure of a surgeon
who performed a long operation rised
up to 140/110 mm Hg. What changes
of humoral regulation could have
caused the rise of arterial pressure in
this case?
A. Activation of kallikrein kinin
system
B. Activation of sympathoadrenal
system
C. Inhibition of sympathoadrenal
system
D. Activation of formation and
excretion of aldosterone
E. Activation of renin angiotensive
system
423. An adult man presents with
systemic arterial pressure drop from
120/70 to 90/50 mm Hg. This resulted
in reflex vasoconstriction.
Vasoconstriction will be minimal in the
following organ:
A. Bowels
B. Liver
C. Heart
D. Skeletal muscles
E. Skin
424. An aged man had raise of
arterial pressure under a stress. It was
caused by activation of:
A. Sympathoadrenal system
B. Functions of thyroid gland
C. Hypophysis function
 E. Parasympathetic nucleus of E. Stimulation of gastrin production
vagus by G-cells

23. Disorders of 428. A patient complains of frequent

Digestive System
425. A 57-year-old patient was
admitted to the gastroenterological
department with suspicion on
Zollinger-Ellison syndrom because of
rapid increase of gastrin level in the
blood serum. What disorder of the
secretory function of the stomach is
the most likely?
A. Hypoacid hyposecretion
B. Hypoacid hypersecretion
C. Hyperacid hypersecretion
D. Hyperacid hyposecretion
E. Achylia
426. After the usage of
acetylsalicylic acid a patient
developed epigastric pain because of
exacerbation of his ulcer. What are
the principles of this medication
ulcerogenity?
A. Immunodepressive effect
B. Cholagogic effect
C. Antiprostaglandinic effect
D. Stimulation of pepsin secretion
E. Spasm of vessels
427. 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. Irritation of mechanoreceptors of
the oral cavity
B. Irritation of taste receptors
C. Stimulation of excretion of
secretin in the duodenum
D. Irritation of mechanoreceptors of
the stomach
diarrheas, especially after consumption
of fattening food, and of body weight
loss. Laboratory examination revealed
steatorrhea; hypocholic feces. What
can be the cause of this condition?
A. Mucous membrane inflammation
of small intestine
B. Obturation of biliary tracts
C. Lack of pancreatic phospholipase
D. Lack of pancreatic lipase
E. Unbalanced diet
429. Secretion of which
gastrointestinal hormones is primerily
decreased in patient with removed
duodenum?
A. Gastrin
B. Histamine
C. Gastrin and histamine
D. Cholecystokinin and secretin
E. Neurotensin
430. During histological examination
of the stomach it was found out that
glands contain very small amount of
pariental cells or they are totally absent.
Mucose membrane of what part of the
stomach was studied?
A. Cardiak part
B. Body of stomach
C. Pyloric part
D. Fundus of stomach
E. -
431. Profuse foam appeared when
dentist put hydrogen peroxide on the
mucous of the oral cavity. What
enzyme caused such activity?
A. Acetyltransferase
B. Glucose-6-
phosphatdehydrogenase
C. Methemoglobinreductase
D. Catalase
E. Cholinesterase

64
 enzymes of pancreatic juice. It is also
432. A mother of a newborn accompanied by increase of rate of the
complains of her baby's constant following enzyme:
belching with undigested milk. Which A. Pepsin
developmental anomaly is it an B. Gastricsin
evidence of? C. Renin
A. Anal atresia D. Tripsin
B. Labium leporium E. Enterokinase
C. Esophageal atresia
D. Faux lupinum 437. A 35 year old man consulted a
E. Esophageal fistula dentist about reduced density of dental
tissue, high fragility of teeth during
433. A 30-year-old woman was eating solid food. This patient suffers
diagnosed with insufficiency of the most probably from the deficiency
exocrinous function of pancreas. of the following mineral element:
Hydrolisis of what nutrients will be A. Iron
disturbed? B. Potassium
A. Proteins C. Magnesium
B. Fats, carbohydrates D. Sodium
C. Proteins, carbohydrates E. Calcium
D. Proteins, fats
E. Proteins, fats, carbohydrates 438. A patient died from acute
cardiac insufficiency, among clinical
434. Examination of a 43 y.o. presentations there was gastrointestinal
patient revealed that his stomach has haemorrhage. Examination of mucous
difficulties with digestion of protein membrane of sromach revealed some
food. Gastric juice analysis revealed defects reaching myenteron; their
low acidity. Function of which gastric edges and bottom were mostly even
cells is disturbed in this case? and loose, some of them contained
A. Endocrinous cells dark-red blood. What pathological
B. Parietal exocrinocytes process was revealed?
C. Mucous cells (mucocytes) A. Thrombosis
D. Main exocrinocytes B. Inflammation
E. Cervical mucocytes C. Erosions
D. Chronic ulcers
435. A patient has a disturbed E. Acute ulcers
absorbtion of fat hydrolysates. It might
have been caused by a deficit in the 439. A patient underwent an
small intestine cavity: operation on account of gall bladder
A. Of bile acids excision that resulted in obstruction of
B. Of bile pigments Ca absorption through the bowels wall.
C. Of lipolytic enzymes What vitamin wil stimulate this
D. Of sodium ions process?
E. Of liposoluble vitamins A. D3
B. C
436. A patient consumed a lot of C. B12
reach in proteins food that caused D. K
increase of rate of proteolytic E. PP

65

440. A male patient has been
diagnosed with gastric ulcer.
Bacteriological examination of biopsy
material from the affected part of
stomach revealed small colonies of
gram-negative, oxide reductase-
positive flexibacteria that grew on the
chocolate agar on the fifth day. Which
of the following microorganisms is the
most likely causative agent?
A. Campilobacter fetus
B. Chlamydia trachomatis
C. Campilobacter jejuni
D. Mycoplasma hominis
E. Helicobacter pylori
441. 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. 7-8 a.m.
B. 10-12 a.m.
C. 3-4 a.m.
D. 5-6 p.m.
E. 2-3 p.m.
442. A 30-year-old male patient
with acute pancreatitis has been found
to have a disorder of cavitary protein
digestion. The reason for such
condition can be the hyposynthesis
and hyposecretion of the following
enzyme:
A. Pepsin
B. Dipeptidase
C. Amylase
D. Lipase
E. Tripsin
443. A doctor recommends a
patient with duodenal ulcer to drink
cabbage and potato juice after the
therapy course. Which substances
contained in these vegetables help to
heal and prevent the ulcers?
66
A. Vitamin K
B. Vitamin C
C. Pantothenic acid
D. Vitamin U
E. Vitamin B1
444. A coprological survey revealed
light-colored feces containing drops of
neutral fat. The most likely reason for
this condition is the disorder of:
A. Bile inflow into the bowel
B. Pancreatic juice secretion
C. Intestinal juice secretion
D. Intestinal absorption
E. Gastric juice acidity
445. A 58-year-old man has a
clinical picture of acute pancreatitis.
The increase of what substance in the
urine from belowmentioned will confirm
the diagnosis?
A. Albumin
B. Nonprotein (rest) nitrogen
C. Urea
D. Uric acid
E. Amylase
446. After intake of rich food a
patient feels nausea and sluggishness;
with time there appeared signs of
steatorrhe a. Blood cholesterine
concentration is 9,2 mmole/l. This
condition was caused by lack of:
A. Chylomicrons
B. Fatty acids
C. Phospholipids
D. Bile acids
E. Triglycerides
24. Liver Pathology
447. M-r S presents all signs of the
hepatic coma: loss of consciousness,
absence of reflexes, cramps,
convulsion, disorder of heart activity,
recurrent (periodical) respiration. What
are cerebrotoxical substances which examination of the following substance
accumulate in blood under hepar exreted by urine:
A. Autoantibody A. Creatinine
B. IL-1 B. Uric acid
C. Ammonia C. Ammonium salts
D. Ketonic body D. Amino acids
E. Necrosogenic substances E. Hippuric acid

448. A 48 y.o. patient was admitted 452. Fatty of phospholipids is

to the hospital with complaints about disordered due to fat infiltration of the
weakness, irritability, sleep liver. Indicate which of the presented
disturbance. Objectively: skin and substances can enhance the process of
scleras are yellow. In blood: methylation during phospholipids
conjugated bilirubin, cholalemi a. synthesis?
Feces are acholic. Urine is of dark A. Glycerin
colour (bilirubin). What jaundice is it? B. Citrate
A. Mechanic C. Methionine
B. Gilbert's syndrome D. Ascorbic acid
C. Parenchymatous E. Glucose
D. Hemolytic
E. Crigler-Najjar syndrome 453. Obturative jaundice developed
in a 60-year-old patient because of
449. After consumption of rich food malignant tumour of the big papillary of
a patient has nausea and heartburn, the duodenal. Lumen of what
steatorrhea. This condition might be anatomical structure is squeezed with
caused by: tumour?
A. Disturbed phospholipase A. Cystic duct
synthesis B. Hepatopancreatic ampulla
B. Increased lipase secretion C. Common hepatic duct
C. Amylase deficiency D. Right hepatic duct
D. Bile acid deficiency E. Left hepatic duct
E. Disturbed tripsin synthesis
454. A 59-year-old man has signs of
450. A patient has yellow skin the parenchymatous jaundice and
colour, dark urine, dark-yellow feces. portal hypertension. On histological
What substance will have examination of the puncture of the liver
strengthened concentration in the bioptate, it was revealed: beam-lobule
blood serum? structure is affected, part of
A. Biliverdin hepatocytes has signs of fat dystrophy,
B. Unconjugated bilirubin port-portal connective tissue septa with
C. Verdoglobin formation of pseudo-lobules,with
D. Mesobilirubin periportal lympho-macrophage
E. Conjugated bilirubin infiltrations. What is the most probable
diagnosis?
451. A patient is ill with A. Alcohol hepatitis
hepatocirrhosis. State of antitoxic liver B. Chronic hepatosis
function can be characterized by C. Viral hepatitis
D. Liver cirrhosis

67
 E. Toxic dystrophy C. Biliverdin
D. Conjugated bilirubin
455. After intake of rich food a E. Unconjugated bilirubin
patient feels nausea and
sluggishness: with time there 459. Blood analysis of a patient with
appeared signs of steatorrhea. Blood jaundice reveals conjugated
cholesterine concentration is 9.2 bilirubinemia, increased concentration
micromole/l. This condition was of bile acids. There is no
caused by lack of: stercobilinogen in urine. What type of
A. Phospholipids jaundice is it?
B. Chylomicrons A. Hepatocellular jaundice
C. Triglycerides B. Parenchymatous jaundice
D. Fatty acids C. Cythemolytic jaundice
E. Bile acids D. Hemolytic jaundice
E. Obstructive jaundice
456. An experimantal animal that
was kept on protein-free diet 460. Jaundice treatment involves
developed fatty liver infiltration, in administration of barbiturates inducing
particular as a result of deficiency of the synthesis of UDP-glucuronyl
methylating agents. This is caused by transferase. A medicinal effect is
disturbed generation of the following caused by the production of:
metabolite: A. Biliverdin
A. Acetoacetate B. Protoporphyrin
B. Cholesterol C. Heme
C. DOPA D. Indirect reacting (unconjugated)
D. Choline bilirubin
E. Linoleic acid E. Direct reacting (conjugated)
bilirubin
457. Hepatitis has led to the
development of hepatic failure. 461. The greater amount of nitrogen
Mechanism of edemata formation is is excreted from the organism in form of
activated by the impairment of the urea. Inhibition of urea synthesis and
following liver function: accumulation of ammonia in blood and
A. Chologenetic tissues are induced by the decreased
B. Barrier activity of the following liver enzyme:
C. Protein-synthetic A. Urease
D. Antitoxic B. Aspartate aminotransferase
E. Glycogen-synthetic C. Carbamoyl phosphate synthetase
D. Pepsin
458. A 46 year old woman suffering E. Amylase
from chololithiasis developed
jaundice. Her urine became dark- 462. A patient presents with
yellow and feces became colourless. icteritiousness of skin, scleras and
Blood serum will have the highest mucous membranes. Blood plasma the
concentration of the following total bilirubin is increased, stercobilin is
substance: increased in feces, urobilin is increased
A. Mesobilirubin in urine. What type of jaundice is it?
B. Urobilinogen A. Obturational

68
 B. Cholestatic 466. A 16 year-old patient got
C. Gilbert's disease numerous traumas in automobile
D. Haemolytic accident. Now the patient is haning a
E. Parenchymatous shock. АP - 80/60 mm Hg. daily urine
volume 60-80 ml. What pathogenic
25. Kidneys Pathology mechanism leads to kidneys function
violation?
A. Increased vasopressin blood
463. Shock and signs of acute
concentration
renal failure (ARF) developed in the
B. Increased osmotic pressure in
patient due to permanent injury. What
glomerular capillaries
is the leading cause of development of
C. Increased pressure in Bowman’s
ARF in the case?
capsule
A. Urine excretion violation
D. Trauma of the urinary bladder
B. Increased pressure in the renal
E. Decreased hydrostatic pressure
arteries
in glomerular capillaries
C. Decreased arterial pressure
D. Decreased oncotic BP
467. Chronic glomerulonephritis was
E. Increased pressure in the
diagnosed in a 34-year-old patient 3
nephron capsule
years ago. Edema has developed
within the last 6 monthes. What caused
464. A 65-year-old suffering from
the edema?
the gout man complains of the pain in
A. Hyperproduction of vasopressin
the kidney's region. On ultrasonic
B. Hyperaldosteronism
examination the renal calculi were
C. Proteinuria
revealed. As a result of what process
D. Liver disfunction of protein
were they formed?
formation
A. Ornithine cycle
E. Hyperosmolarity of plasma
B. Heme decay
C. Decay of purine nucleotides
468. The low specific gravity of the
D. Protein catabolism
secondary urine (1002) was found out
E. Restoration of cysteine
in the sick person. Wat is the most
distant part of nephron where
465. Glomerular filtration rate
concentration of secondary urine takes
(GFR) increased by 20% due to
place?
prolonged starvation of the person.
A. In ascending part of loop of Henle
The most evident cause of filtration
B. In the collecting duck
changes under this conditions is:
C. In the nephron’s glomerulus
A. Increase of filtration coefficient
D. In distal tubule of nephron
B. Increase of penetration of the
E. In proximal tubule of nephron
renal filter
C. Decrease of oncotic pressure of
469. A 58-year-old patient with acute
blood plasma
cardiac insufficiency has decreased
D. Increase of systemic blood
volume of daily urine - oliguria. What is
pressure
the mechanism of this phenomenon?
E. Increase of renal plasma stream
A. Rise of hydrostatic blood pressure
in capillars
B. Decreased glomerular filtration

69
 C. Reduced permeamility of renal
filter
D. Decreased number
functioning glomerules
E. Drop of oncotic blood pressure
470. Examination of a 43 y.o.
anephric patient revealed anemia
symptoms. What is the cause of these
symptoms?
A. Folic acid deficit
B. Vitamin B12 deficit
C. Reduced synthesis of
erythropoietins
D. Enhanced destruction of
erythrocytes
E. Iron deficit
471. Violation of safety rules
resulted in calomel intoxication. Two
days later the daily diuresis was 620
ml. A patient experienced headache,
vomiting, convulsions, dyspnea, moist
rales in lungs. What pathology is it?
A. Chronic renal insufficiency
B. Acute renal insufficiency
C. Glomerulonephritis
D. Uraemic coma
E. Pyelonephritis
472. A driver who got a trauma in a
road accident and is shocked has
reduction of daily urinary output down
to 300 ml. What is the main
pathogenetic factor of such diuresis
change?
A. Secondary hyperaldosteronism
B. Drop of arterial pressure
C. Increased vascular permeability
D. Decreased number of
functioning glomerules
E. Drop of oncotic blood pressure
473. A 30 year old woman has face
edemata. Examination revealed
proteinuria (5,87 g/l),
hypoproteinemia, dysproteinemia,
hyperlipidemia. What condition is the
set of these symptoms typical for?
of A. Chronic renal failure
B. Acute renal failure
C. Nephrotic syndrome
D. Chronic pyelonephritis
E. Nephritic syndrome
474. As a result of long-term
starvation the glomerular filtration of a
man was accelerated by 20%. The
most probable cause of filtration
changes under such conditions is:
A. Rise of systemic arterial pressure
B. Growth of filtration coefficient
C. Increase of renal plasma flow
D. Increased permeability of renal
filter
E. Fall of oncotic pressure of blood
plasma
475. For a long time a 49-year-old
woman was suffering from
glomerulonephritis which caused death.
On autopsy it was revealed that
kidneys size was 7х3х2.5 sm, weight is
65,0 g, they are dence and small-
grained. Microscopically: 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
organs?
A. Anemia
B. Sepsis
C. DIC-syndrome
D. Thrombopenia
E. Uraemia
476. Patient complains of frequent
and difficult urination. Imperfection of
what formation can cause it?
A. Bulb-uretic glands
B. Testicle adnexa
C. Prostate
D. Testicles
E. Sperm bubbles
70

477. Periodic renal colics attackes
are observed in the woman with
primery hyperparathyroidizm.
Ultrasonic examination revealed small
stones in the kidneys. What is the
cause of the formation of the stones?
A. Hypercholesterinemia
B. Hyperuricemia
C. Hyperkalemia
D. Hypercalcemia
E. Hyperphosphatemia
478. 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 urine of:
A. Phosphates
B. Chlorine
C. Sodium
D. Calcium
E. Potassium
479. On the 6th day of treatment a
patient with acute renal insufficiency
developed polyuria. Diuresis
intensification at the beginning of
poliuria stage of acute renal
insufficiency is caused by:
A. Growth of natriuretic factor
B. Volume expansion of circulating
blood
C. Reduction of vasopressin
content in plasma
D. Renewal of filtration in nephrons
E. Reduction of aldosteron content
in plasma
480. A patient has a decreased
vasopressin synthesis that causes
polyuria and as a result of it evident
organism dehydratation. What is the
mechanism of polyuria development?
A. Reduced tubular reabsorption of
protein
71
B. Acceleration of glomerular
filtration
C. Reduced tubular reabsorption of
Na+ ions
D. Reduced tubular reabsorption of
water
E. Reduced glucose reabsorption
481. 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. Renin
B. Vasopressin
C. Angiotensin
D. Aldosterone
E. Natriuretic hormone
482. Examination of a patient
suffering from cancer of urinary bladder
revealed high rate of serotonin and
hydroxyanthranilic acid. It is caused by
excess of the following amino acid in
the organism:
A. Alanine
B. Tyrosine
C. Tryptophan
D. Methionine
E. Histidine
483. A concentrated solution of
sodium chloride was intravenously
injected to an animal. This caused
decreased reabsorption of sodium ions
in the renal tubules. It is the result of
the following changes of hormonal
secretion:
A. Reduction of atrial natriuretic
factor
B. Aldosterone increase
C. Aldosterone reduction
D. Vasopressin increase
E. Vasopressin reduction
484. A patient complains of polyuria
(7 liters per day) and polydipsia.
Examination reveals no disorders of E. Aldosterone increase
carbohydrate metabolism. These
abnormalities might be caused by the 488. A 38-year-old male patient has
dysfunction of the following endocrine been ill with systemic lupus
gland: erythematosus for three years. He was
A. Adenohypophysis diagnosed with diffuse renal affection
B. Adrenal cortex accompanied by massive edemata and
C. Islets of Langerhans (pancreatic expressive proteinuria. What is the
islets) most likely cause of proteinuria
D. Neurohypophysis development?
E. Adrenal medulla A. Aseptic renal affection
B. Urinary bladder inflammation
485. A patient with massive burns C. Urinary tracts inflammation
developed acute renal insufficiency D. Autoimmune renal affection
characterized by a significant and E. Ischemic renal affection
rapid deceleration of glomerular
filtration. What is the mechanism of its 26. Disorders of
development?
A. Reduction of functioning Endocrine System
nephron number
B. Rise of pressure of tubular fluid 489. A 2-year-old child
C. Reduction of renal blood flow experienced convulsions because of
D. Renal artery embolism lowering calcium ions concentration in
E. Damage of glomerular filter the blood plasma. Function of what
structure is decreased?
486. A 36-year-old female patient A. Thymus
has a history of collagen disease. B. Pineal gland
Urine analysis is likely to reveal an C. Parathyroid glands
increased concentration of the D. Adrenal cortex
following metabolite: E. Hypophysis
A. Urea
B. Indican 490. A 50-year-old patient complains
C. Creatinine of thirst, drinking of a lot of water,
D. Oxyproline marked polyuria. Blood glucose is
E. Urobilinogen 4,8mmol/L, urine glucose and acetone
bodies are absent, urine is colorless,
487. A concentrated solution of specific gravity is 1,002-1,004. What is
sodium chloride was intravenously the cause of polyuria?
injected to an animal. This caused A. Aldosteronism
decreased reabsorption of sodium B. Thyrotoxicosis
ions in the renal tubules. It is the result C. Vasopressin insufficiency
of the following changes of hormonal D. Insulin insufficiency
secretion: E. Hypothyroidism
A. Reduction of atrial natriuretic
factor 491. Arterial hypertension,
B. Vasopressin reduction hyperglycemia, glucosuria were
C. Vasopressin increase observed clinically for a long time in the
D. Aldosterone reduction patient with upper type of obesity.

72
Death was due to the cerebral B. Insulin-dependent diabetes
haemorrhage. Basophilic hypophysis mellitus
adenoma, hyperplasia of adrenal C. Type I glycogenosis
gland cortex were revealed on D. Myxoedema
pathomorphological examination. E. Addison's disease
What is the likely diagnosis?
A. Cushing disease 495. A patient complaining of
B. Diabetes mellitus weight loss (10 kg during 2 months),
C. Acromegaly pallpitation and exophthalmos came to
D. Hypophysis nanism the endocrinologist. For the
E. Adiposogenitalis dystrophy hyperfunction of what endocrine gland
(glands) are these complaints the most
492. The person has decreased typical?
diuresis, hypernatremia, hypokalemia. A. Pancreas
Hypersecretion of what hormon can B. Ovaria
cause such changes? C. Parathyroid glands
A. Vasopressin D. Adrenal glands
B. Adrenalin E. Thyroid
C. Aldosterone
D. Auricular sodiumuretic factor 496. Careless student
E. Parathormone occasionaly met his dean. The
concentration of what hormone will
493. Increased production of most likely increase in the blood of the
thyroidal hormones T3 and T4, weight student?
loss, tachycardia, psychic excitement A. Thyrotropin-releasing hormone
and so on present on thyrotoxicosis. B. Cortisol
How do thyroidal hormones effect C. Somatotropin
energy metabolism in the D. Corticotropin
mitochondrion of cells? E. Adrenalin
A. Stops phosphorylation of
substance 497. A 26-year-old woman is
B. Activates phosphorylation of complaining of thirst and dryness in her
substance mouth. The examination has revealed
C. Disconnect oxidation and glucosuria and blood glucose content of
oxidated phosphorylation 6,5 mmol/l. What condition are these
D. Stops respiratory chain symptoms the most typical for?
E. Activates oxidated A. Diabetes insipidus
phosphorylation B. Steroid diabetes
C. Diabetes mellitus
494. The patient with complaints of D. Renal diabetes
permanent thirst applied to the doctor. E. Alimentary glucosuria
Hyperglycemia, polyuria and
increased concentration of 17- 498. A man because of 1,5 litre
ketosteroids in the urine were blood loss has suddenly reduced
revealed. What disease is the most diuresis. The increased secretion of
likely? what hormone caused such diuresis
A. Steroid diabetes alteration?
A. Parathormone

73
 B. Vasopressin
C. Natriuretic 502. A 19-year-old female suffers
D. Corticotropin from tachycardia in rest condition,
E. Cortisol weight loss, excessive sweating,
exophtalmos and irritability. What
499. Some diseases reveal hormone would you expect to find
symptoms of aldosteronism with elevated in her serum?
hypertension and edema due to A. ACTH
sodium retention in the organism. B. Mineralocorticoids
What organ of the internal secretion is C. Cortisol
affected on aldosteronism? D. Insulin
A. Hypophysis E. Thyroxine
B. Testicle
C. Ovaries 503. A patient had been taking
D. Pancreas glucocorticoids for a long time. When
E. Adrenal glands the preparation was withdrawn he
developed the symptoms of disease
500. There is only one hormone aggravation, decreased blood pressure
among the neurohormones which and weakness. What is the reason of
refers to the derivatives of amino this condition?
acids according to classification. Point A. Hyperproduction of ACTH
it out: B. Appearance of adrenal
A. Melatonin insufficiency
B. Vasopressin C. Sensibilization
C. Oxytocin D. Habituation
D. Thyroliberin E. Cumulation
E. Somatotropin
504. A patient suffering from
501. A 46 year-old patient has thyrotoxicosis symptoms of
complained of headache, fatigue, vegetoasthenic syndrome was
thirst, pains in the spine and joints for revealed. What of the following would
the last 2 years. Clinically observed show the histological appearance of a
disproportional enlargement of hands, thyroid gland being stimulated by
feet, nose, superciliary arches. He thyroid-stimulating hormone (TSH)?
notes that he needed to buy bigger A. Increased numbers of
shoes three times. What is the main parafollicular cells
reason of such disproportional B. Decreased numbers of follicular
enlargement of different parts of the cells
body? C. Decreased numbers of
A. Increased sensitivity of the parafollicular capillaries
tissues to growth hormone D. An abundance of colloid in the
B. Joints dystrophy development lumen of the follicle
C. Joints chronic inflammation E. Columnar-shaped follicular cells
development
D. Increased sensitivity of the 505. A 40-year-old patient complains
tissues to insulin of intensive heartbeats, sweating,
E. Cartilaginous tissue proliferation nausea, visual impairment, arm tremor,
under growth hormone influence hypertension. From his anamnesis: 2

74
years ago he was diagnosed with resorbtion of calcium ions and
pheochromocytoma. Hyperproduction decreased resorbtion of phosphate
of what hormones causes the given ions. What hormone causes this
pathology? phenomenon?
A. Aldosterone A. Hormonal form D3
B. Catecholamines B. Parathormone
C. Glucocorticoids C. Aldosterone
D. Thyroidal hormones D. Thyrocalcitonin
E. ACTH E. Vasopressin

506. Thyrotoxicosis leads to 509. A patient with infectious

increased production of thyroidal mononucleosis had been taking
hormones T3 and T4, weight loss, glucocorticoids for two weeks. He was
tachycardia, psychic excitement and brought into remission, but he fell ill
so on. How do thyroidal hormones with acute attack of chronic tonsillitis.
effect energy metabolism in the What action of glucocorticoids caused
mitochondrion of cells? this complication?
A. Activate oxidative A. Immunosuppressive
phosphorylation B. Antiinflammatory
B. Disconnect oxidation and C. Antishock
oxidative phosphorylation D. Antiallergic
C. Stop substrate phosphorylation E. Antitoxic
D. Activate substrate
phosphorylation 510. Intake of oral contraceptives
E. Stop respiratory chain containing sex hormones inhibits
secretion of the hypophysiae
507. A 44-year-old woman hormones. Secretion of which of the
complains of common weakness, indicated hormones is inhibited while
heart pain, considerable increase of taking oral contraceptives with sex
body weigt. Objectively: moon-like hormones?
face, hirsutism, AP- 165/100 mm Hg, A. Thyrotropic
height - 164 cm, weight - 103 kg; fat is B. Follicle-stimulating
mostly accumulated in the region of C. Somatolropic
neck, upper shoulder girdle, stomach. D. Oxytocin
What is the main pathogenetic E. Vasopressin
mechanism of obesity?
A. Decreased production of 511. A girl is diagnosed with
glucagon adrenogenital syndrome
B. Increased production of (pseudohermaphroditism). This
glucocorticoids pathology was caused by
C. Increased production of hypersecretion of the following adrenal
mineralocorticoids hormone:
D. Increased production of insulin A. Androgen
E. Decreased production of B. Estrogen
thyroidal hormones C. Aldosterone
D. Adrenalin
508. Kidneys of a man under E. Cortisol
examination show increased

75
 512. Rats being under stress have
muscular hypertonia and high arterial
pressure, high glucose concentration
in blood and intensified secretion of
corticotropin and corticosteroids. In
what stress phase are these animals?
A. Terminal
B. Erectile
C. Exhaustion
D. Antishock phase
E. Shock phase
513. A 59 year old patient is a plant
manager. After the tax inspection of
his plant he felt intense pain behind
his breastbone irradiating to his left
arm. 15 minutes later his condition
came to normal. Which of the possible
mechanisms of stenocardia
development is the leading in this
case?
A. Functional heart overload
B. High catecholamine
concentration in blood
C. Intravascular aggregation of
blood corpuscles
D. Coronary thrombosis
E. Coronary atherosclerosis
514. Parents of a 10 year old boy
consulted a doctor about extension of
hair-covering, growth of beard and
moustache, low voice. Intensified
secretion of which hormone must be
assumed?
A. Of progesterone
B. Of oestrogen
C. Of cortisol
D. Of somatotropin
E. Of testosterone
515. A concentrated solution of
sodium chloride was intravenously
injected to an animal. This caused
decreased reabsorption of sodium
ions in the renal tubules. It is the result
of the following changes of hormonal
secretion:
76
A. Aldosterone increase
B. Vasopressin increase
C. Aldosterone reduction
D. Vasopressin reduction
E. Reduction of atrial natriuretic
factor
516. 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
hormon with what cell substance is this
action caused?
A. Nuclear receptors
B. Membrane receptors
C. Ribosomes
D. Chromatin
E. Proteins- activators of
transcription
517. Person felt thirsty after staying
in heat for a long time. Signals of what
receptors caused it first of all?
A. Osmoreceptors of the liver
B. Glucoreceptors of hypothalamus
C. Baroreceptors of aortic arch
D. Osmoreceptors of hypothalamus
E. Sodium receptors of
hypothalamus
518. Patient was on glucocorticoids
for a long time, discontinuation of
usage caused exacerbation of the
illness, decreased BP, weakness. How
can you explain it?
A. Adaptation to the medicine
B. Sensitization
C. Hyperproduction of ACTH
D. Insufficiency of adrenal glands
E. Cumulation
519. During pubescence the cells of
male sexual glands begin to produce
male sex hormon testosterone that
calls forth secondary sexual characters.
What cells of male sexual glands
produce this hormone?
A. Spermatozoa
 B. Leidig cells formations, cysts. Bony tissue was
C. Sustentocytes substituted by fibrous connective
D. Supporting cells tissue. Examination revealed also
E. Sertoli's cells adenoma of parathyroid gland and
hypercalcemia. What is the most
520. Inhabitants of territories with probable diagnosis?
cold climate have high content of an A. Osteopetrosis
adaptive thermoregulatory hormone. B. Parathyroid osteodystrophy
What hormone is meant? C. Paget's disease
A. Glucagon D. Osteomyelitis
B. Insulin E. Myelomatosis
C. Cortisol
D. Thyroxin 524. A 4 year old child with
E. Somatotropin hereditary renal lesion has signs of
rickets, vitamin D concentration in
521. A patient suffering from blood is normal. What is the most
pheochromocytoma complains of probable cause of rickets
thirst, dry mouth, hunger. Blood test development?
for sugar revealed hyperglycemia. A. Impaired synthesis of calcitriol
What type of hyperglycemia is it? B. Lack of calcium in food
A. Adrenal C. Hypofunction of parathyroid
B. Alimentary glands
C. Hypercorticoid D. Hyperfunction of parathyroid
D. Somatotropic glands
E. Hypoinsulinemic E. Increased excretion of calcium

522. Examination of a 42 year old 525. Emotional stress causes

patient revealed a tumour of activation of hormon-sensitive
adenohypophysis. Objectively: the triglyceride lipase in the adipocytes.
patient's weight is 117 kg, he has What secondary mediator takes part in
moon-like hyperemic face, red-blue this process?
striae of skin distension on his belly. A. Diacylglycerol
Osteoporosis and muscle dystrophy B. Ions of Са2+
are present. AP is 210/140 mm Hg. C. Cyclic guanosine monophosphate
What is the most probable diagnosis? D. Cyclic adenosine monophosphate
A. Cushing's syndrome E. Adenosine monophosphate
B. Conn's disease
C. Cushing's disease 526. Cardinal symptoms of primary
D. Essential hypertension hyperparathyroidism are osteoporosis
E. Diabetes mellitus and renal lesion along with
development of urolithiasis. What
523. A 50 year old patient has been substance makes up the basis of these
taking treatment thrice for the last 6 calculi in this disease?
months because of fractures caused A. Uric acid
by domestic accidents. Microscopical B. Bilirubin
examination of bony tissue revealed C. Cystine
foci of lacunar resolution, giant-cell D. Cholesterol
granulomas in the tumour-like E. Calcium phosphate

77
 C. Glucagon
527. The secretion of whixh D. Somatotropin
hypophysial hormones will be inhibited E. Thyrocalcitonin
after taking the oral contraceptives
containing sex hormones? 531. A patient has been given high
A. Ocytocin doses of hydrocortisone for a long time.
B. Thyrotrophic hormone This caused atrophy of one of the
C. Vasopressin adrenal cortex zones. Which zone is it?
D. Gonadotropic hormone A. Reticular
E. Somatotropic hormone B. Fascial
C. Glomerular and reticular
528. A female patient presents with D. Glomerular
endocrine dysfunction of follicular cells E. -
of the ovarian follicles resulting from
an inflammation. The synthesis of the 27. Disorders of CNS
following hormone will be inhibited:
A. Lutropin
B. Follistatine 532. A 68-year-old woman can't
C. Estrogen move by the upper and lower right
D. Follicle stimulating hormone extremities due to insult. Muscle tone
E. Progesterone of these extremities and reflexes are
increased. There are pathological
529. A 46-year-old patient suffering reflexes. What form of the paralysis is
from the diffuse toxic goiter underwent it?
resection of the thyroid gland. After A. Hemiplegia
the surgery the patient presents with B. Tetraplegia
appetite loss, dyspepsia, increased C. Monoplegia
neuromuscular excitement. The body D. Dissociation
weight remained unchanged. Body E. Paraplegia
temperature is normal. Which of the
following has caused such a condition 533. Due to cranial trauma the
in this patient? patient developed the symptoms:
A. Reduced production of thyroxin intention tremor, dysmetry,
B. Reduced production of adiadochokinesis, dysarthria. What
parathormone structure of the brain is injured?
C. Increased production of A. Striatum
thyroliberin B. Motor cortex
D. Increased production of C. Cerebellum
calcitonin D. Pale sphere
E. Increased production of thyroxin E. Black substance

530. A 32-year-old patient 534. A patient after hypertension

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. Vasopressin
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. Reflex paresis

78
 B. Peripheral paresis
C. Central paresis
D. Central paralysis
E. Peripheral paralysis
535. A student is thoroughly
summarising 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. Dying
B. Differential
C. External
D. Protective
E. Delayed
536. A 60-year-old patient was
diagnosed with hypothalamic lateral
nuclei stroke. What changes in
patient’s behavior may be expected?
A. Thirst
B. Aggressive behaviour
C. Unsatisfied hunger
D. The rejection of food
E. Depression
537. Inhibition of alpha-motoneuron
of the extensor muscles was noticed
after stimulation of α-motoneuron of
the flexor muscles during the
experiment on the spinal column.
What type of inhibition can be caused
by this process?
A. Recurrent
B. Reciprocal
C. Presynaptic
D. Depolarizational
E. Lateral
538. 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. Liquid of the anterior chamber of
eye
B. Vitreous body
79
C. Muscle that dilatates pupil
D. Cornea
E. Lens
539. A 50-year-old patient was
injured on the occipital region of the
head. The closed skull trauma was
diagnosed. She was taken to the
hospital. The medical examination:
deregulation of walking and balance,
trembling of arms. What part of brain
was injured?
A. The mind-brain
B. The inter-brain
C. The cerebellum
D. The spinal cord
E. The medulla oblongata
540. Microspecimen of spinal cord
contains a nucleus that should be
analyzed. Its neurons form motor
endings in the skeletal muscles. What
nucleus of spinal cord is meant?
A. Intermediate lateral nucleus
B. Proper nucleus of the posterior
horn
C. Proper nucleus of gray substance
D. Proper nucleus of the anterior
horn
E. Thoracic nucleus
541. When a patient with traumatic
impairment of the brain was examined,
it was discovered that he had stopped
to distinguish displacement of an object
on the skin. What part of the brain was
damaged?
A. Frontal central gurus
B. Frontal zone
C. Posterior central gurus
D. Parietal zone of the cortex
E. Occipital zone of the cortex
542. A 60-year-old patient has
reduced perception of high-frequency
sounds. What structures' disorder of
auditory analizer caused these
changes?
 A. Eustachian tube
B. Main membrane of cochlea near
helicotrema
C. Muscles of middle ear
D. Tympanic membrane
E. Main membrane of cochlea near
the oval window
543. A 60-year-old man after
cerebral hemorrhage felt asleep for a
long time. Damage of what structure
caused this state?
A. Hippocampus
B. Nuclears of the cerebral nerves
C. Cortex of the large hemispheres
D. Reticular formation
E. Black substances
544. An experimental rat with
extremity paralysis has no tendon and
cutaneous reflexes, muscle tone is
decreased, but muscles of the
affected extremity maintain their ability
to react with excitation to the direct
action of continious current. What type
of paralysis is it?
A. Flaccid peripheral
B. Extrapyramidal
C. Spastic central
D. Flaccid central
E. Spastic peripheral
545. 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. Partial tetanus
B. A series of single contractions
C. Muscle contracture
D. Holotetanus
E. Asynchronous tetanus
546. As a result of spinal-cord
trauma a 33 y.o. man has a disturbed
pain and temperature sensitivity that is
80
caused by damage of the following
tract:
A. Lateral spinocortical
B. Anterior spinocerebellar
C. Medial spinocortical
D. Spinothalamic
E. Posterior spinocerebellar
547. 54 Vagi of an experimental
animal were cut on both sides. What
respiration changes will be observed?
A. It will become shallow and
infrequent
B. It will become deep and frequent
C. It will become deep and
infrequent
D. It will become shallow and
frequent
E. No changes will be observed
548. A 28 year old man had a
gunshot wound of shin that resulted in
an ulcer from the side of the injury.
What is the main factor of
neurodystrophy pathogenesis in this
case?
A. Microcirculation disturbance
B. Tissue damage
C. Traumatization of peripheral
nerve
D. Infection
E. Psychical stress
549. The ventral roots of 5 frontal
segment of spinal cord were cut during
experiment in the animal. What
changes will take place in the
innervation region?
A. Loss of temperature sensitivity
B. Loss of proprioceptive sensitivity
C. Loss of movements
D. Loss of touch sensitivity
E. Hypersensitivity
550. Vegetative abnormalities in the
sleep, heat regulation, all kinds of
metabolism, diabetes insipidus are
developing in the patient due to grouth
of the tumour in the III ventricle of substances absorbed by the
brain. Irritation of the nucleus of what bloodstream from the intestines was
part of the brain can cause this revealed. What substances that are
symptoms? created in the intestines can cause
A. Hypothalamus endotoxemia?
B. Cerebral peduncles (cruces A. Acetacetate
cerebri) B. Biotin
C. Mesencephalic tegmentum C. Ornithine
D. Pons cerebelli D. Indole
E. Medulla E. Butyrate

551. Middle part of cochlear of 555. Accelerated frequency of the

internal ear was destroyed in animal
while experiment. It will cause
abnormalities of the sound perception
of the following frequencies:
A. Low
B. High
C. High and low
D. No abnormalities
E. Middle
552. 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 appears?
A. Asynchronous
B. Continuous(smooth) tetanus
C. Waved tetanus
D. Single
E. Tonic
heart rate and increased blood
pressure were marked in the sportsman
on the start before the competitions.
Influence of what parts of the CNS can
explain these changes?
A. Mesencephalon
B. Diencephalon
C. Hypothalamus
D. Cortex of the large hemispheres
E. Medulla
556. As a result of damage to certain
structures of brainstem an animal lost
orientation reflexes. What structures
were damaged?
A. Vestibular nuclei
B. Red nuclei
C. Black substance
D. Medial nuclei of reticular
formation
E. Quadritubercular bodies

553. A patient has a haemorrhage 557. Glutamate decarboxylation

into the posterior central gyrus. What
type of sensitivity on the opposite side
will be disturbed?
A. Auditory
B. Skin and proprioceptive
C. Visual
D. Olfactory
E. Auditory and visual
554. Patient with encephalopathy
was admitted to the neurological in-
patient department. Correlation of
increasing of encephalopathy and
results in formation of inhibitory
transmitter in CNS. Name it:
A. Glutathione
B. GABA
C. Serotonin
D. Histamine
E. Asparagine
558. A 63 y.o. man with collapse
symptoms was delivered to the
emergency hospital. A doctor chose
noradrenaline in order to prevent

81
hypotension. What is the action
mechanism of this medication?
A. Activation of dopamine receptors
B. Block of M-cholinoreceptors
C. Activation of serotonin receptors
D. Activation of β-adrenoreceptors
E. Activation of α-adrenoreceptors
559. Ammonia is a very toxic
substance, especially for nervous
system. What substance takes the
most active part in ammonia
detoxication in brain tissues?
A. Lysine
B. Glutamic acid
C. Histidine
D. Proline
E. Alanine
560. 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. Visual
B. Vestibular
C. Proprioceptors
D. Auditory
E. Tactors
561. A patient staggers and walks
astraddle. He has hypomyotonia of
arm and leg muscles, staccato
speech. In what brain section is this
affection localized?
A. Cerebellum
B. Red nucleus
C. Caudate nucleus
D. Motor cortex
E. Putamen
562. A patient got an injury of
spinal marrow in a road accident that
caused loss of tactile sensation,
posture sense, vibration sense. What
conduction tracts are damaged?
A. Anterior spinocerebellar tract
B. Tectospinal tract
82
C. Fascicle of Goll and cuneate
fascicle
D. Rubrospinal tract
E. Reticulospinal tract
563. A patient got a trauma that
caused dysfunction of motor centres
regulating activity of head muscles. In
what parts of cerebral cortex is the
respective centre normally localized?
A. Inferior part of precentral gyrus
B. Angular gyrus
C. Superior parietal lobule
D. Superior part of precentral gyrus
E. Supramarginal gyrus
564. A patient was diagnosed with
paralysis of facial and masticatory
muscles. The haematoma is inside the
genu of internal capsule. What
conduction tract is damaged?
A. Tr. cortico-fronto-pontinus
B. Tr. cortico-thalamicus
C. Tr. cortico-temporo-parieto-
occipito-pontinus
D. Tr. cortico-spinalis
E. Tr. cortico-nuclearis
565. In course of an experiment
thalamocortical tracts of an animal were
cut. What type of sensory perception
remained intact?
A. Visual
B. Olfactory
C. Auditory
D. Exteroreceptive
E. Nociceptive
566. An infectious disease caused
contractive activity of muscles that
contract and dilate eye pupil (paralytic
state). What functional eye system was
damaged?
A. Photosensory
B. Accomodative
C. Lacrimal apparatus
D. Dioptric
E. Ancillary

567. A patient underwent an
extraction of a part of a CNS
structures by medical indications. As a
result of the extraction the patient
developed atony, astasia, intention
tremor, ataxy and adiadochokinesis.
Which part of CNS structure had been
extracted?
A. Cerebellum
B. Limbic system
C. Basal ganglions
D. Amygdaloid corpus
E. Hippocamp
568. After a craniocerebral trauma
a patient 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 parahippocampalis
B. Gyrus paracentralis
C. Gyrus angularis
D. Gyrus lingualis
E. Gyrus supramarginalis
569. A man who is riding the
carousel presents with increased
heart rate, sweating, nausea. This
condition is caused primarily by the
stimulation of the following receptors:
A. Auditory
B. Vestibular otolithic
C. Visual
D. Proprioceptors
E. Vestibular ampullar
570. 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. Postcentral gyrus
B. Occipital
C. Frontal
D. Parietal
83
E. Temporal
571. A 75-year-old-female patient
with 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. Left and right halves of both eyes
retina
C. Left and right halves of the right
eye retina
D. Left and right halves of the left
eye retina
E. Right half of both eyes retina
572. A 49-year old female patient
has limitation 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
hypertension and hyperreflexia?
A. Motoneuron activation induced by
stroke
B. Activation of excitatory influence
from the focus of stroke
C. Reduction of descending
inhibitory influence
D. Activation of synaptic
transmission
E. Ihibition of cerebral cortex
motoneurons
84
 29. Answers to the Tests
1. E 51. A 101. E 151. A 201. C 251. D 301. C 351. E 401. A 451. E
2. B 52. C 102. A 152. E 202. E 252. A 302. A 352. D 402. A 452. C
3. C 53. B 103. B 153. B 203. C 253. D 303. C 353. D 403. D 453. B
4. C 54. B 104. C 154. D 204. A 254. E 304. D 354. E 404. D 454. D
5. C 55. E 105. D 155. A 205. A 255. A 305. A 355. A 405. B 455. E
6. E 56. B 106. B 156. B 206. C 256. E 306. B 356. A 406. B 456. D
7. B 57. C 107. D 157. C 207. D 257. B 307. A 357. A 407. E 457. C
8. C 58. E 108. E 158. D 208. A 258. B 308. B 358. B 408. E 458. D
9. D 59. C 109. D 159. B 209. E 259. D 309. C 359. D 409. D 459. E
10. D 60. C 110. D 160. D 210. C 260. A 310. E 360. C 410. C 460. E
11. A 61. E 111. A 161. D 211. B 261. E 311. E 361. D 411. D 461. C
12. A 62. D 112. E 162. E 212. A/D 262. D 312. D 362. B 412. B 462. D
13. E 63. B 113. A 163. B 213. C 263. C 313. A 363. E 413. A 463. C
14. E 64. C 114. B 164. E 214. D 264. B 314. E 364. C 414. A 464. C
15. C 65. A 115. C 165. C 215. E 265. A 315. E 365. A 415. A 465. C
16. D 66. A 116. B 166. C 216. C 266. A 316. A 366. B 416. D 466. E
17. A 67. E 117. C 167. E 217. E 267. C 317. A 367. A 417. E 467. C
18. B 68. D 118. D 168. D 218. E 268. D 318. B 368. E 418. D 468. B
19. E 69. A 119. D 169. A 219. C 269. D 319. E 369. B 419. C 469. B
20. A 70. D 120. C 170. E 220. D 270. C 320. A 370. B 420. C 470. C
21. A 71. D 121. A 171. A 221. C 271. D 321. E 371. A 421. B 471. B
22. E 72. E 122. E 172. D 222. C 272. C 322. C 372. E 422. B 472. B
23. A 73. D 123. A 173. C 223. A 273. B 323. D 373. D 423. C 473. C
24. C 74. E 124. D 174. E 224. E 274. E 324. E 374. C 424. A 474. E
25. B 75. E 125. C 175. C 225. E 275. A 325. D 375. E 425. C 475. E
26. C 76. D 126. D 176. B 226. B 276. A 326. D 376. A 426. C 476. C
27. C 77. D 127. E 177. E 227. B 277. A 327. E 377. C 427. E 477. D
28. A 78. B 128. B 178. D 228. B 278. A 328. C 378. E 428. B 478. E
29. B 79. C 129. C 179. B 229. E 279. C 329. C 379. E 429. D 479. D
30. D 80. C 130. D 180. E 230. D 280. A 330. B 380. B 430. C 480. D
31. A 81. E 131. C 181. C 231. D 281. A 331. E 381. B 431. D 481. E
32. A 82. A 132. E 182. D 232. D 282. D 332. D 382. C 432. C 482. C
33. C 83. D 133. B 183. B 233. C 283. A 333. A 383. C 433. E 483. C
34. E 84. E 134. C 184. E 234. A 284. B 334. D 384. B 434. B 484. D
35. B 85. E 135. D 185. C 235. C 285. B 335. A 385. C 435. A 485. C
36. E 86. E 136. C 186. E 236. D 286. D 336. A 386. A 436. D 486. D
37. A 87. B 137. D 187. D 237. D 287. D 337. C 387. D 437. E 487. D
38. E 88. C 138. A 188. D 238. B 288. A 338. A 388. E 438. E 488. D
39. E 89. A 139. A 189. D 239. D 289. D 339. D 389. C 439. A 489. C
40. C 90. A 140. E 190. A 240. B 290. E 340. E 390. C 440. E 490. C
41. A 91. E 141. D 191. D 241. E 291. B 341. E 391. A 441. D 491. A
42. B 92. D 142. A 192. C 242. C 292. B 342. C 392. D 442. E 492. C
43. A 93. E 143. A 193. E 243. C 293. C 343. A 393. B 443. D 493. C
44. E 94. D 144. B 194. E 244. B 294. C 344. E 394. B 444. A 494. A
45. C 95. A 145. D 195. C 245. C 295. C 345. D 395. B 445. E 495. E
46. C 96. A 146. E 196. A 246. B 296. E 346. C 396. D 446. D 496. E
47. C 97. E 147. E 197. C 247. C 297. A 347. A 397. A 447. C 497. D
48. D 98. C 148. C 198. E 248. E 298. C 348. D 398. E 448. A 498. B
49. D 99. A 149. A 199. B 249. E 299. C 349. A 399. E 449. D 499. E
50. D 100. A 150. B 200. A 250. B 300. C 350. C 400. C 450. B 500. A

501. E 511. A 521. A 531. B 541. C 551. E 561. A 571. A

 502. E 512. D 522. C 532. A 542. E 552. C 562. C 572. C
503. B 513. B 523. B 533. C 543. D 553. B 563. A 573.
504. E 514. E 524. A 534. D 544. A 554. D 564. E 574.
505. B 515. C 525. D 535. C 545. D 555. D 565. B 575.
506. B 516. A 526. E 536. D 546. D 556. E 566. B 576.
507. B 517. D 527. D 537. B 547. C 557. B 567. A 577.
508. B 518. D 528. C 538. E 548. C 558. E 568. E 578.
509. A 519. B 529. B 539. C 549. C 559. B 569. E 579.
510. B 520. D 530. A 540. D 550. A 560. B 570. E 580.

RECCOMENDED LITERATURE

1. Stephen J. McPhee. Pathophysiology of Disease. An introduction to

Clinical Medicine / Stephen J. McPhee, William F. Ganong // Lunge Medical
Books/McGraw-Hill. – 5th edition. – 2006. – 761 p.
2. Pathophysiology: concepts of altered health states / [edited by] Carol
Mattson Porth, Glenn Matfin. – 8th ed. Copyright © Wolters Kluwer Health I
Lippincott Williams & Wilkins. – 2009. – p. 1688.
3. Pathophysiology-Патофізіологія: підручник / Н.К. Сімеонова; за
науковою редакцією В.А. Міхньова. – К.: ВСВ «Медицина», 2010. – 544 с.
4. General and clinical pathophysiology / Edited by Anatoliy V. Kubyshkin –
Vinnytsia: Nova Knuha Publishers – 2011.
5. Handbook of general and Clinical Pathophysiology / Edited by prof.
A.V.Kubyshkin. – CSMU. – 2005.
6. Pathophysiology / Edited by prof. Zaporozan. – OSMU. – 2005.
7. Essentials of Pathophysiology: Concepts of Altered Health States
(Lippincott Williams & Wilkins), Trade paperback / Carol Mattson Porth, Kathryn J.
Gaspard. – 2003.
8. J.B.Walter I.C.Talbot General pathology. Seventh edition. – 1996.
9. Robbins and Cotran Pathologic Basis of Disease 7th edition / Kumar,
Abbas, Fauto. – 2006.
10. Pathophysiology, Concepts of Altered Health States, Carol Mattson Porth,
Glenn Matfin. – New York, Milwaukee. – 2009.
11. http://testcentr.org.ua/
12. http://kroktest.org.ua/kroki/krok-1/foreign-tests/examination-tests-or-
booklets-foreign-students-englishstep-1
13. http://online.kroktest.org.ua/

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