Англійська ПМК2 153-200

In the area being the epicenter of the registered rabies cases among wild animals a 43-year-old man presented to a clinic and claimed to have been bitten by a stray dog. He was given a course of anti-rabies vaccine. This preparation relates to the following type of vaccines:

A patient has a history of chronic obstructive bronchitis. Blood gas analysis revealed the development of hypoxemia and hypercapnia on the background of dyspnea, tachycardia and cyanosis. What disorder of external respiration is observed in the patient?

A 55-year-old mae patient with acute heart failure has been administered a quick-relief cardiac glycoside. Which of the following drugs has been given to the patient?

A 64-year-old male patient died with symptoms of acute cardiovascular failure. Autopsy results: the section of the anterior wall of the left ventricle showed a yellowish flaccid 1,5-2 cm focus surrounded by a reddish rim. The convoluted coronary arteries had lumen irregularly narrowed by 75%. The vessel intima was thickened, dense, covered with whitish plaques, crunched when cut. What disease can you think of?

A 25-year-old patient with a hereditary enzymopathy (Gilbert’s disease) has a disorder of bilirubin conjugation in liver. What enzyme is not synthesized in this patient?

Pyruvic acid as an intermediate metabolite of carbohydrate, lipid and amino acid metabolism can undergo oxidative decarboxylation. The cause of this process is the lack of the following nutrient in the diet:

A patient with diabetes mellitus developed ketoacidotic coma due to the acid-base disturbance. What type of disorder had arisen in this case? 

Inadequate treatment of middle ear inflammation (mesotympanitis) has resulted in suppurative inflammation of the cells of temporal bone mastoid process (mastoiditis). The abscess has erupted into the bed of sternocleidomastoid muscle. This pathological process is localised in the following cervical fascia:

What vitamin is a component of glutamic acid decarboxylase, participates in the production of GABA, and its deficiency is manifested by seizures?

A 36-year-old injured with a knife wound of neck has bleeding. The blood is dark. During the wound management it was revealed that a vessel in the anterior part of the neck below the hyoid bone was damaged. Identify this vessel:

Postmortem examination of a patient with a long history of rheumatism revealed thickening and shortening of the mitral valve leaflets with abundant thrombotic deposits. Histological examination of the valve leaflets confirmed sclerosis and revealed multiple foci of connective tissue disorganization in form of mucoid and fibrinoid swelling, as well as deendothelization foci. Endothelium defects were covered with thrombotic deposits of 1-2 mm. What type of valvular endocarditis is the case?

As a result of an injury a child developed an abscess of adipose tissue of cheek. With time the process spread to the lateral surface of pharynx. The pus spread along the following fascia: 

After a diver had dived to a depth of 60 meters he got the following symptoms of CNS dysfunction: anxiety, euphoria, lack of attention, professional errors. These symptoms are associated with neurons being under a toxic effect of:

A 4-year-old girl died suddenly with symptoms of asphyxia. Autopsy revealed white spots on the buccal mucosa; large blotches of rash on the skin of face, trunk and extremities; conjunctivitis, edema with foci of necrosis on the laryngeal mucosa; giant-cell pneumonia on microscopy. What is the most likely diagnosis? 

Examination of a 6-year-old patient gave reasons to suspect the deterioration in airway patency. What is the most reliable research method to identify the pathology?

When examining the oral caity of a 22-year-old patient, the dentist noticed a destroyed medial tubercle on the cutting edge of the right maxillary first molar. This tubercle is called:

Depressions and emotional disorders result from noradrenaline, serotonin and other biogenic amines deficiency in brain. Concentration of these compounds in synapses can be increased by means of antidepressants that inhibit the activity of the following enzyme:

As a result of a development anomaly a newborn has malformation of major salivary glands. This anomaly is caused by the damage of the following embryonal structure:

Following thyroid surgery, a 47-yearold female patient had fibrillary twitching of muscles in the arms, legs and face. These disorders can be treated by the introduction of the following hormone:

A paitent, who works as a milkmaid, has made an appoinment with a dentist with complaints of aphtha-shaped rash on the mucosa of oral cavity. The doctor detected rash on her hands in the area of nail plates. What agent causes this disease?

It is known that many hormones act through the adenylate cyclase system causing the enzyme activation by phosphorylation. What enzyme is activated by hormonal signals and catalyzes glycogen breakdown?

During manipulations aimed at treatment of mandible dislocation a physician should pay particular attention to a muscle that pulls a capsule and interarticular disc of temporomandibular articulation exteriorly. What muscle is it?

Examination of a 28-year-old patient with hepatocerebral degeneration revealed an impairment of ceruloplasmin synthesis. This defect is associated with the following organelles:

A patient has been diagnosed with sepsis. It was decided to treat him with a drug from the fluoroquinolone group. Specify this drug:

Ultrasonography of a pregnant revealed no abnormalities in the cardiovascular system of the fetus, the ductus arteriosus had a normal function. What vessels does it connect?

A female patient has referred to a dentist with complains of bruise and swelling around her eye. Anamnesis is as follows: several days prior her 1st premolar tooth had been extracted, with infraorbital anesthesia administered; several days later hematoma appeared in the area of foramen intraorbitale. Branch of the followingartery was damaged:

 Oral mucosa of a patient was treated with hydrogen peroxide. Instead of foaming, the blood turned brown. That is possible in case of reduced concentration of the following enzyme:

If a trait is determined mostly by genetic factors, the percentage of concordance between the twins is much higher in monozygotic twins than in dizygotic ones. What is the percentage of blood group concordance in monozygotic twins?

A 28-year-old patient had been diagnosed with multifragmental fracture of the right hip. On the third day after the injury he began to complain of pain in the right side of chest, difficult respiration. A day later the patient died of progressive heart and respiratory failure. Histological study of pulmonary and cerebral blood vessels revealed orange sudanophilic droplets that completely obstructed the vessels of microvasculature. What complication caused the death of the patient? 

Squamous part of temporal bone and the artery situated on its inner surface have been damaged in the result of inflicted gunshot wound. What artery is it?

Certain brain structures of test animals have been subjected to electrostimulation, as an experiment, resulting in development of polyphagia (abnormal desire to consume excessive amounts of food) in test animals. Electrodes have been inserted in the following brain structures:

The total number of leukocytes in patient’s blood is 90 · 1 0 9/l. Leukogram: eosinophils - 0%, basophils - 0%, juvenile - 0%, stab neutrophils - 2%, segmentonuclear cells - 20%, lymphoblasts - 1%, prolymphocytes - 2%, lymphocytes 70%, monocytes - 5%, Botkin-Gumprecht cells. Clinical examination revealed enlarged cervical and submandibularlymph nodes. Such clinical presentations are typical for the following patholog y :/l. Leukogram: eosinophils - 0%, basophils - 0%, juvenile - 0%, stab neutrophils 2%, segmentonuclear cells - 20%, lymphoblasts - 1%, prolymphocytes - 2%, lymphocytes - 70%, monocytes - 5%, Botkin-Gumprecht cells. Clinical examination revealed enlarged cervical and submandibular lymph nodes. Such clinical presentations are typical for the following pathology:

A 43-year-old patient has acute pancreatitis with concomitant disruption of common bile duct patency. What condition can it result in? 

Vitamin-like substance choline is contained in phospholipids which are the main components of biological membranes. What sulphur-containing amino acid serves as the donor of methyl groups for the synthesis of choline?

A 25-year-old patient got an injury as a result of which a portion of the nail plate was removed. What structures will be responsible for its restoration?

A patient has been prescribed pyridoxal phosphate. What processes are corrected with this drug?

A 46-year-old patient with diabetes had been admitted to a hospital in grave precomatose condition. Study of the acid-base balance revealed metabolic acidosis. What is the primary mechanism that underlies the revealed changes of the acid-base balance? 

A newborn boy has been diagnosed with hydrocephalus. Doctors consider it to be caused by teratogenic factors. What germ layers are affected by teratogen?

 Physical activity caused an increase in the cardiac output in a patient with a transplanted heart. What regulative mechanism is responsible for these changes?

A 57-year-old patient with coronary artery disease has been administered an anti-anginal agent that activates guanylate cyclase and accumulates myocardial cGMP. What drug is it?

A patient has chronic rhinitis. Nasal cavity mucosa swelling causes disruption of the olfactory nerve receptors placed in the nasal cavity olfactory region. What formation allows for olfactory nerve endings to enter into anterior cranial fossa?

A 36-year-old patient with a several year history of chronic pulpitis had undergone tooth extraction. Microscopic examination of the pulp revealed some deep-purple structureless areas which can be interpreted as:

A patient visited a dentist for acute dental pain in the lower left canine. He was diagnosed with pulpitis. What nerve innervates this tooth?

A 47-year-old patient with symptoms of severe intoxication and respiratory failure died. A section of lung tissue had a mottled pattern with multiple small focal hemorrhages and foci of emphysema. Histological examination revealed hemorrhagic bronchopneumonia accompanied by abscess; the cytoplasm of bronchial epithelial cells had eosinophil and basophil inclusions. According to the section analysis, make your diagnosis:

A patient with a toxic paralysis of the respiratory center has been repeatedly administered cordiamine for the center stimulation. What side effect may occur? 

An animal had been intensively fed with carbohydrates. Histologic examination of its liver revealed a significant number of glycogen granules. Glycogen relates to the following group of cell structures:

Examination of the oral cavity of a 19-year-old patient revealed a small gap between the maxillary and mandibular incisors. There was no contact between the front teeth. Specify the type of occlusion in this patient:

A patient with arterial hypertension has developed a bronchial asthma attack. Which of the following bronchodilators may provoke a hypertensive crisis?ay provoke a hypertensive crisis?