Англійська ПМК2 (250-300)

250. After a patient had taken a blocking agent, his heart rate (HR) increased. Pressing on the eyeballs didn’t result in the expected reflectory decrease in heart rate. What exactly was blocked by the drug in the pacemaker cells?

251. A 39-year-old patient with arthritis of the temporomandibular joint has been administered diclofenac sodium. It must be kept in mind that the side effect of prolonged use of this drug is:

252. A patient has petechial hemorrhages on the gums, hard and soft palate, buccal mucosa. This is caused by the dysfunction of the following blood corpuscles:

253. A histological specimen represents an organ whose wall consists of the mucosa, submucosa, fibrocartilage and adventitious cartilage. The organ is lined by pseudostratified ciliary epithelium, the muscular layer of the mucosa is absent, the submucosa contains seromucous glands. Hyaline cartilage C-rings are present. What organ has the described morphological characteristics?

254. During a hypertensive crisis a patient has had a hemorrhagic stroke resulting in a lack of voluntary movements, increased tendon reflexes and muscle tone of the left arm and leg. What is this motor dysfunction called?

255. Peripheral nerve trauma causes muscle atrophy; bones become porous and brittle; sores appear on skin and mucosa. What function of nervous system is damaged?

256. A bacteriological laboratory studied the home-made dried fish which had caused a severe food poisoning. Microscopy of the culture grown on the Kitt-Tarozzi medium revealed microorganisms resembling a tennis racket. What is the most likely diagnosis?

257. Denture installation has caused excessive salivation in patient. It is caused by the following reflexes:

258. An injured person with a wound of forearm radial surface has been brought to a surgical department. Venous bleeding of the wound is observed. What blood vessel is damaged?

259. A patient with marked manifestations of exsicosis died in the infectious disease hospital. Postmortem examination results: the corpse with contracted muscles, dry skin and mucous membranes, thick and dark blood in veins, edematous plethoric mucosa, distended bowel loops, the lumen contains about 4 liters of ricewater fluid. What is the most likely diagnosis?

260. A patient presented to a hospital with complaints about quick fatigability and significant muscle weakness. Examination revealed an autoimmune disease that causes functional disorder of receptors in the neuromuscular synapses. This will result in the disturbed activity of the following mediator:

261. A histological preparation shows organ, where lymphocytes form three types of lymphoid structures: lymph nodules, medullary cords and lymphatic sinuses. What organ is it?

262. At the recruiting office US examination of a 19-year-old man revealed nephroptosis. Normally the kidneys should be located at the following vertebral level:

263. A 68-year-old female patient with a history of glaucoma has increased intraocular pressure with normal secretion of aqueous humor by ciliary body. The inadequate outflow of fluid from the anterior chamber is associated with the damage to the following structure of the eyeball wall:

264. During allergic rhinitis (inflammation of the nasal mucosa) the number of basophils in the connective tissue of the mucosa increases, which is accompanied by a tissue edema. This phenomenon is associated with the following function of tissue basophils:

265. A 2-year-old child has congenital spastic contraction of muscles on one side of neck, that is torticollis. What muscle is affected?

266. A patient is diagnosed with acute morphine hydrochloride poisoning. Choose the oxidant drug to be prescribed for gastric lavage.

267. A 28-year-old patient complains of frequent gingival haemorrhages. Blood test revealed the clotting factor II (prothrombin) deficiency. What phase of blood coagulation is impaired in this patient?

268. An unconscious patient had been delivered to a hospital by the ambulance. Objectively: absent reflexes, occasional convulsions, irregular breathing. After a laboratory examination he was diagnosed with hepatic coma. What metabolite accumulation is essential for the development of the central nervous system disorders?

269. Preventive examination of 1-1.5year-old children living in an orphanage revealed focal thickening of ribs and wrists, bowed legs. The dentist pointed out delayed teething, wrong eruption order, irregularmineralization of the enamel and dentin, high-arched palate. What disease has developed in children?

270. As a result of a rapid change from horizontal to vertical body position a 16year-old girl lost consciousness. What is the reason for it?

271. A patient consulted a doctor about difficult chewing. On examination he was found to have the atrophy of the right temporal muscle and masticatory muscles. Upon opening the mouth, the patient’s jaw deviates to the left. What nerve isaffected?

272. Hormonal form of a certain vitamin induces genome level synthesis of Ca-binding proteins and enterocytes thus regulating the intestinal absorption of C a2 +ions required for dental tissue development. What vitamin is it?

273. 6 hours after the initial inoculation of water sample into 1% peptone water, the growth of a culture in form of a thin pellicle on the medium surface was registered. Such cultural properties are typical for the causative agent of the following disease:

274. Steatosis is caused by accumulation of triacylglycerols in hepatocytes. One of the mechanisms of this disease is to reduce the utilization of neutral fat VLDL. What lipotropic substances prevent the steatosis development?

275. Following the estimation of a person’s energy expenditures it was established that the respiratory quotient was equal to 1,0. This means that the compound that is mainly oxidized in the cells is:

276. Histological study of a microslide of human skin found only dense irregular connective tissue. Which layer of this organ was analysed?

277. A 12-year-old male patient has tetanic convulsions. Which gland function may be impaired in this case?

278. During the formation of mantle dentin the synthetic activity of odontoblasts was disturbed, which will have an effect on the formation of the following fibers:

279. A 24-year-old patient with catarrhal tonsillitis has ben administered a drug from the group of sulfonamides. Specify the mechanism of sulfonamide antibacterial action:

280. A 23-year-old patient with diabetes has hyperglycemia at the rate of 19 mmol/l which is clinically manifested by glucosuria, polyuria, polydipsia. Which of the listed below mechanisms is responsible for the development of glycosuria?

281. After the exposure to ionizing radiation a person was found to have a decrease in blood granulocyte level. What mechanism underlies these changes?

282. Biogenic amines, such as histamine, serotonin, dopamine and others, are highly active substances affecting various physiological functions. What transformation process of aminoacids results in biogenic amines being produced in somatic tissues?

283. An examination of a 26-year-old patient involved histological analysis of bone marrow punctate which revealed a significant decrease in the number of megakaryocytes. At the same time the following blood corpuscles should be decreased in number:

284. When examining a female patient a doctor observed the following: misshapen auricles, elevated palate, teeth growth disorder; mental retardation; no disruption of reproductive function. Provisional diagnosis is the "super woman"syndrome. Point out the karyotype of this disease.

285. In course of a surgery the surgeon needs to expose spatium antescalenum. What structure forms the posterior border of this space?

286. Mother of a 10-year-old boy with purulent gingivitis consulted a dentist about the possibility of gingivitis treatment with fluoroquinolone drugs. The doctor gave a negative answer explaining it by the fact that fluoroquinolones:

287. A 38-year-old man died all of a sudden. Autopsy revealed myocardial infarction in the posterior wall of the left ventricle. What are the most likely alterations in myocardiocyte structure that can be revealed microscopically in the infarction focus?

288. Continuous treatment of cancer patients with methotrexate over time reduces the target cell’s sensitivity to the drug. In this case gene amplification of the following enzyme is observed:

289. There is high content of proteine and erythrocytes in urine. This can be caused by increased:

290. A 32-year-old female has gingivitis accompanied by gingival hypoxia. At the same time, the level of the following metabolite of carbohydrate metabolism is greatly increased in periodontal tissues:

291. A histological preparation of lower jaw shows dentin being formed. Collagen fibers synthesized by odontoblasts are thin and situated perpendicular to dentinal tubules. What fibers are being produced in dentin?

292. A 39-year-old patient underwent hematologic tests. The following results were obtained: RBC- 2,8 · 1012/L, Нb-80 g/L, color index - 0,85, reticulocytes - 0,1%, platelets - 160 · 109/L, WBC 60 · 1 0 9/L. Basophils - 2, eosinophils - 8, promyelocytes - 5, myelocytes - 5, immature neutrophils - 16, stab neutrophils - 20, segmented neutrophils - 34, lymphocytes - 5, monocytes 5. What form of blood pathology are these results indicative of?

293. A rounded whitish-pink tumor node with diameter of 6 cm has been removed from uterine cavity. Microscopy revealed it to consist of chaotically arranged smooth muscle fibers with large amount of stroma threaded through with nerves and blood vessels. What diagnosis is most probable?

294. After arriving in the polar region, researchers from Australia have complained of nervous disorders, loss of appetite, aggravation of chronic diseases for 6 months. What process has been disrupted in extreme conditions?

295. A patient with a long history of chronic periodontitis underwent removal of a maxillary cyst located at the root of the affected tooth. Microscopy shows that the bone wall is made up of fibrous tissue infiltrated by lymphocytes and plasma cells. The inner surface of the cyst is covered with stratified squamous epithelium with no signs of keratinization. What is the most likely diagnosis?

296. A female patient suffering from coronary artery disease has been prescribed amiodarone that has antianginal action. What other action does this drug have?

297. The aim of the morphological study was to investigate an endocrine gland with parenchyma consisting of epithelium and neural tissue. In the epithelial trabeculae the study revealed two types of cells: chromophile and chromophobe. Identify this organ:

298. Cytogenetic analysis established that the patient had the 47, XYY karyotype. The extra chromosome in the karyotype has a centromere located very close to one of the chromosome ends so that one chromosomal arm is much shorter than the other one. Such a chromosome is called:

299. A patient, who had been eating only polished rice, developed polyneuritis caused by thiamine deficiency. What compound can be indicative of this kind of avitaminosis when excreted with urine?

300. Histological specimen of mandible shows 10 tooth buds connected to the dental plate. Which element of tooth germ will develop out of them?