Англійська ПМК2 (401-450)

401. A 53-year-old patient with a long history of nephrolithiasis underwent nephrectomy. The kidney looks as a thin-walled sac filled with urine. Renal parenchyma is atrophied. Specify this complication of nephrolithiasis:

402. There are various diseases that cause sharp increase of active oxygen, leading to cell membranes destruction. Antioxidants are used to prevent it from happening. The most potent natural antioxidant is:

403. A 45-year-old female patient has neurosis with irritability, insomnia, amotivational anxiety. What tranquilizer will be able to eliminate all symptoms of the disease?

404. A 23-year-old patient with acute pulpitis has elevated body temperature and an increase in the WBC count up to 14 · 1 0 9/L. The leucogram is as follows: basophils - 0, eosinophils - 2, monocytes - 0, immature neutrophils - 4, stab neutrophils - 8, segmented neutrophils - 56, lymphocytes - 26, monocytes - 4. How can we interpret these changes in the white blood cells?

405. In a bacteriological laboratory some bacterial smears had to be stained by Gram’s method. For this purpose the following reagents were prepared: gentian violet, Lugol’s solution, aqueous fuchsin solution. What other reagent is required?

406. A patient undewent radiography that revealed numerous smooth-walled roundish defects in both jaws. Histological study revealed osteolysis and osteoporosis accompanied by the phenomena of poor bone formation. The patient’s urinecontained BenceJones protein. What is the most likely diagnosis?

407. A patient with a pronounced icteritiousness of skin, sclera and mucous membranes has urine of dark beer colour and colourless feces. Direct bilirubin in blood is elevated, urine contains bilirubin. What type of jaundice is it?

408. A pregnant women developed severe toxemia with exhausting recurrent vomiting throughout a day. By the end of the day she developed tetanic convulsions and bodily dehydration. The described changes were caused by the following type of acid-base disbalance:

409. A 34-year-old patient has low endurance of physical loads. At the same time skeletal muscles have increased concentration of glycogen. This is caused by the reduced activity of the following enzyme:

410. Autopsy of a dead man with no fixed abode revealed the aneurysm of the ascending aorta. Microscopy of the middle tunica of aorta revealed lymphocytic inflammatory infiltrates, plasma cells, fibroblast cells with some Pirogov-Langhans cells, endovasculitis. What disease should be suspected?

411. A patient is diagnosed with seborrheic dermatitis caused by vitamin H (biotin) deficiency. Observed is activity disruption of the following enzyme:

412. It is known that the pentose phosphate pathway occuring in the adipocytes of adipose tissue acts as a cycle. What is the main function of this cycle in the adipose tissue?

413. A patient with periodontitis has developed gingival edema. The gums are of dark red colour. What local circulation disorder prevails in the gums of the patient?

414. In case of some helminthiases, an affected person can detect helminth himself because mature segments of the causative agent are able to crawl out of the anus. This is typical for the following disease:

415. A child is 6 years old. The permanent teeth have started to take the place of the primary teeth. What teeth are the first to emerge?

416. During reproduction of some RNA-containing viruses that cause tumors in animals, genetic information can be transmitted in the opposite direction from the RNA to the DNA via a specific enzyme. The enzyme of reverse transcription is called:

417. A 40-year-old patient was revealed to have blood clotting time of 2 minutes under a stressful condition. It is primarily caused by the following hormon affecting hemocoagulation:

418. In the dental practice, the vitality of tooth tissues is estimated by electric pulp test. What parameter is assessed?

419. As a result of a trauma a patient has developed traumatic shock. The patient is fussy, talkative, pale. AP- 140/90 mm Hg, Ps-120 bpm. This condition is consistent with the following shock phase:

420. Calcification of dental tissues is significantly influenced by osteocalcin protein which has an ability to bind calcium ions due to the presence of the following modified amino acid residues in the polypeptide chain:

421. A 39-year-old patient has been suffering from gastric ulcer for the last 4 years. His condition exacerbates in spring and autumn: he suffers from pain in epigastrium, heartburn, nausea, constipation. What nosological term can be applied to the period between two exacerbations?

422. A patient consulted a doctor about an increased pain sensitivity of the ear skin and ear canal. Palpation behind the sternocleidomastoid muscle was painful. Such clinical presentations are typical for the irritation of the following nerve:

423. For an unknown reason the fertilization membrane of an embryo dissolved in the fallopian tube in the first critical period. What complication of pregnancy is possible in this case?

424. A patient complains of frequent bowel movements and stool with blood admixtures ("raspberry jelly"stool). Microscopic examination revealed large mononuclear cells with absorbed red blood cells. What protozoon is this morphological structure typical for?

425. Stimulation of the peripheral segment of chorda tympani in an experimenal animal resulted in the discharge of the following secretion from the parotid salivary fistula:

426. Degeneration of glycogen in liver is stimulated by glucagon. What secondary messenger (mediator) is thus formed in the cell?

427. In some anaerobic bacteria the pyruvate produced by glycolysis is converted to the ethyl alcohol (alcoholic fermentation). What is the biological significance of this process?

428. To conduct serum diagnostics of typhoid fever a test is carried out, when diagnosticums of three types of microorganisms are being added into different solutions of patient’s serum; then agglutinate formation is checked. Name the author of this kind of test.

429. Microelectrode technique allowed to register a potential following "all-ornone"law and being able of undecremental spreading. Specify this potential:

430. A patient has lost his ability to recognize objects by their characteristic sounds (clock, bell, music). What part of his brain is damaged?

431. A 49-year-old patient was found to have a disproportionate enlargement of hands, feet, nose, ears, superciliary arches and cheek bones. Blood test revealed hyperglycemia, impaired glucose tolerance. What is the most likely cause of this pathology development?

432. A patient at the early stage of diabetes mellitus was found to have polyuria. What is its cause?

433. An 18-year-old patient complains of general weakness, fatigue, low spirits. The patient is of the asthenic constitution type. Ps- 68/min., AP- 90/60 mm Hg. She has been found to have primary neurocirculatory hypotension. What is the leading factor of the arterial pressure drop in this patient?

434. Preventive examination of a 55year-old patient revealed type II diabetes mellitus. An endocrinologist revealed an increase in body weight and liver enlargement. The man is non-smoker and doesn’t abuse alcohol but likes to have a good meal. Histological examination by means of diagnostic liver puncture revealed that the hepatocytes were enlarged mostly on the lobule periphery, their cytoplasm had transparent vacuoles showing positive reaction with sudan III. What liver pathology was revealed?

435. A 28-year-old liquidator of Chernobyl disaster consulted a doctor about marked weakness, skin hemorrhages, diarrhea. Blood test results: ESR- 25 mm/h, RBC- 2,4 · 1012/L, WBC - 2,2 · 109/L, platelets 70·1 0 9/L. What stage of acute radiation sickness are these presentations typical for?

436. A 20-year-old male got his tongue pierced. 5 months later a dense pale pink formation appeared in the zone of puncture. Biopsy revealed growing connective tissue with focal clusters of single polymorphonuclear neutrophils, fibroblasts, foreign body cells, lymphocytes and plasmocytes. What kind of pathological process developed in the tongue tissues?

437. A tumour pressing upon the vegetative nucleus of a cranial nerve causes saliva secretion by the parotid gland. What nucleus does the tumor press upon?

438. A pregnant woman complains of vaginal mucosa irritation, itching and genital tracts secretion. Bacterioscopy of vaginal smears revealed large gram-positive oval oblong cells that form pseudomicelium. What is the most probable channel of infection?

439. Normal implantation of human embryo is possible only if uterus endometrium undergoes certain changes, with the following type of endometrium cells increasing in number:

440. In the perianal folds of a 5-year-old girl mother found white worms causing itch and anxiety, and took them to the laboratory. The study revealed white filament-like helminths 0,5-1 cm long, with pointed, sometimes twisted, ends. What diagnosis can be made?

441. A patient with mandibular osteomyelitis shows the signs of plexus dentalis inferior damage and innervation disruption of his mandibular teeth and gums. What nerve provides this innervation with its branches?

442. DNA replication occurs during the cell division when a signal is received from the cytoplasm, and a certain portion of the DNA helix is unwound and divided into two chains. The helix is unwound by the following enzyme:

443. A hospital in Donetsk region admitted the patients - members of the same family - with eyelid and face edemata, fever, eosinophilia, headache, muscle pain. The disease developed on the 7-10 day after eating pork sausage sent by the patients’ relatives from Khmelnitsky region. What is your provisional diagnosis?

444. Mother and father are healthy. Mother underwent amniocentesis for fetal karyotyping. The fetal karyotype turned out to be 45, XO. What syndrome can be expected in a newborn baby?

445. Examination of the oral mucosa revaled a small nodule with papillary surface. Histological examination revealed conjugate papillary proliferations of stratified squamous epithelium without cellular atypism and underlying stroma represented by thin-walled vessels and loose connective tissue. What formation has developed in a patient?

446. After examining the patient the doctor recommended him to eliminate rich meat and vegetable broth, spices, smoked products from the diet, since the patient was found to have:

447. Microscopy of colonic biopsy material revealed a tumour made up of prismatic epithelium and forming atypical glandular structures of various shapes and sizes. The basal membrane of glands was destroyed. Tumour cells were polymorphic, with hyperchromatic nuclei and a large number of pathological mitoses. What is the most likely diagnosis?

448. Histologically, the internal wall of a maxillary cyst is lined with stratified squamous epithelium with underlying granulation tissue with infiltrating lymphocytes. The outer layer is represented by loose fibrous connective tissue surrounded by cicatrical fibrous tissue. What diagnosis can be made?

449. A 37-year-old patient has has lost 5 kg in weight over the past three months, he complains of hand tremor, excessive sweating, exophthalmos, tachycardia. These changes might have been caused by the increased secretion of the following hormone:

450. Autopsy of a 52-year-old woman with a long history of chronic glomerulonephritis revealed significantly reduced in size, dense kidneys with a surface of fine granularity; fibrinous inflammation of serous and mucous membranes; dystrophic changes in parenchymatous organs; cerebral edema. The described changes of serous membranes and internal organs are caused by the following complication: