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A patient has been diagnosed with bacillary dysentery. What drug of those listed below should be prescribed?

205. During anesthesia of the oral mucosa a

37-year-old patient has had anaphylactic reaction (widespread vasodilation, increased vascular permeability with liquid exiting the blood vessels and penetrating in the tissues). What type of hypersensitivity reaction occurred in the patient?

206. Mother had noticed her 5-year-old child’s urine to become dark in colour. Bile pigments in urine were not detected. The diagnosis of alkaptonuria was made. What pigment is deficient?

207. Periodontitis induces the development of lipid peroxidation in the periodontal tissues, as well as an increase in malondialdehyde and hydrogen peroxide concentration in the oral cavity. Which of the following enzymes provides antioxidant protection?

208.It has been revealed that intense physical exercise causes activation of gluconeogenesis in liver of experimantal rats. Which substance is glucose precursor in this case?

209. A patient with symptoms of acute heart failure, namely pallor, acrocyanosis and rapid shallow breathing, has been delivered to the emergency department. Which of these drugs is indicated in this case?

210.An electron microphotograph of duodenal epithelium clearly shows a cell with electron-dense granules in the basal pole. What cell is it?

211. A 47-year-old male patient consulted a dentist about difficult mouth opening (lockjaw). The patient has a history of a stab wound of the lower extremity. What infection can be manifested by these symptoms?

212. A patient with liver cirrhosis has been given intravenously 500,0 ml of 5% glucose solution along with other drugs. There is a high risk of the following water-electrolytic balance disruption:

213. A 36-year-old patient consulted an ophthalmologist about eye ache. The examination revealed the erosion of the cornea, that is the lack of superficial and spinous layers of the epithelium.What cells will provide regeneration of the damaged epithelium?

214. The emergency department admitted a 48-year-old male with a blunt abdominal injury on the right and a suspected rupture of liver. Which of these peritoneal structures can be expected to include blood accumulations?

215. A 9-year-old child has multiple lesions of the oral mucosa in form of small painful hyperemic sores with a white deposit in the center; enlarged and painful submandibular lymph nodes. Microscopic examination of the affected region revealed a superficial defect covered by fibrin; edematic and hyperemic submucosa with inflammatory infiltration. What is the most likely diagnosis?

216. Histological study of the bronchial wall

and adjacent lung segments revealed sheets and

strands of squamous epithelium. The cells have

moderately expressed symptoms of atypia:

polymorphism, nuclear hyperchromatism, mitoses.

In the center of the complex there are concentric

pink formations. What is the most likely diagnosis?

217. A patient consulted a doctor about loss of taste at the root of tongue. The doctor established that this was due to a nerve damage. What nerve was damaged?

218. A 58-year-old male patient consulted an urologist about acute pain during urination and decreased amount of the excreted urine. Urolithiasis was suspected. The concrements are most likely to be found in the following part of the urethra:

219. A student who unexpectedly met his girlfriend developed an increase in systemic arterial pressure. This pressure change was caused by the intensified realization of the following reflexes:

220.A patient has enamel erosion. What vitamin should be administered for its treatment?

221. A patient presents with dysfunction of shin muscles. He cannot raise his body by standing on tiptoe. Which muscle is affected?

222. The patient’s examination in a hospital specialised in diseases of nervous system has revealed absence of light-induced miosis. It is caused by damage of the following brain structures:

223. The surgically excised connective tissue of the deformed mitral valve gives a basophilic reaction when stained with hematoxylin and eosin. When stained with toluidine blue it turns purple (metachromasia). What changes of the connective tissue can be detected by such reactions?

2. A 1-year-old child with the symptoms of affection of limb and trunk muscles had been admitted to a hospital. Examination revealed muscle carnitine deficiency. The biochemical basis of this pathology is a disruption of the following process:

3. A man visited Lebanon. Soon after return he felt pain and heaviness in the perineum and suprapubic region. On examination he was diagnosed with urogenital schistosomiasis. In what way could he become infected?

4. Examples of human-specific parasites are malaria plasmodium, enterobius vermicularis and some other. The source of invasion of such parasites is always a human. Such human-specific parasites cause diseases that are called:

5. A histological specimen of submandibular salivary gland represents basket cells from which some processes radiate and embrace the secretory unit. Contraction of the processes of these cells helps in expelling secretions from the lumen of secretory units and moving them to the system of excretory ducts. Name these cells:

6. A patient, who has been suffering from severe injury of thorax, went into shock followed by symptoms of acute renal failure. What is the primary mechanism of acute renal failure development in this case?

7. Electrophoretic study of blood serum of a patient with pneumonia revealed an increase in one of the protein fractions. What fraction is it?

8. A 12-year-old child is of short stature, has disproportionate body structure and mental retardation. These characteristics might be caused by the hyposecretion of the following hormone:

9. A 44-year-old patient with obstructive jaundice has been admitted to a hospital with the symptoms of cholemic syndrome. On the ECG arrhythmia shows up. What kind of arrhythmia is the patient most likely to have?

10. A patient has herpetic conjunctivitis. What etiotropic drug should be administered?

11. In the armpits of a patient the small (1-1,5 mm), dorsoventrally flattened, wingless, blood-sucking insects. Their larvae developed in the armpits too. What disease is caused by these insects?

12. A histologic study of a red bone marrow puncture sample had been conducted in the course of examination of a 35-year-old patient, and significant megakaryocyte number depletion was detected. What peripheral blood changes will result from that?

A 39-year-old patient consulted a dentist about having a dry area of the oral mucosa beneath the tongue on the right. The dentist revealed a compression of chorda tympani as it exits to the right infratemporal fossa through the following fissura:

14. A 36-year-old male patient frequently has herpes sores on the lips and oral mucosa. Infection recurrences are associated with the persistence of the virus in the body. The herpes simplex virus is most likely to reside in:

15. A dentist has detected symptoms of parodontosis in a patient. What antiprotozoal drug should be prescribed?

16. A 56-year-old female patient is registrated in a psychoneurologic dispensary due to her suffering from epilepsy, specifically, minor attacks (pti mal). What drug is most efficient in this case?

17. It was established that the conduction velocity in the nerve fibers was equal to 120 m/sec. Specify these fibers:

18. A patient has myocardial infarction. The first several hours of such medical condition will be characterized by significant increase of activity of the following enzyme in his blood serum:

19. Pyrogenal administered to a rabbit, in the course of an experiment, resulted in increase of its body temperature. What substance of those named below acts as a secondary pyrogen that is a part of feverinducing mechanism?

20. A patient suffers from a severe lifethreatening generalised septic infection. What group of chemotherapeutical drugs should be prescribed in this case?

21. A patient has been diagnosed with a haemorrhage in the region of the lateral sulcus of the brain. As a result, the blood flow is disturbed in the following artery:

22. Histological examination of a tissue sample revealed that the tissue had no blood vessels, and the cells were packed tightly together making layers. Specify this tissue:

23. After a severe stress a patient was found to have eosinopenia. A decrease in the eosinophil number can be explained by the changed concentration of the following hormones:

24. The effect of some harmful factors caused focal damage to the gastric epithelium. What cells are responsible for its regeneration?

25. In a 52-year-old patient with chronic glomerulonephritis, the glomerular filtration rate (GFR) was reduced by 20% compared to normal. What causes the decrease in GFR in patients with chronic renal failure?

26. An irregular-shaped dense grey and white focus has appeared on the patient’s oral cavity mucosa, raising above mucosa surface. The patient considers it to be denture-caused damage of mucosa. Microscopy has revealed the following: hyperplasia, hyperkeratosis, parakeratosis, acanthosis of stratified epithelium of mucosa; underlaying connective tissue has lymphoplasmacytic infiltration. What pathology is it?

27. When students pass an exam, they often complain of having "dry mouth". The mechanism underlying the development of this condition is the activation of the following processes:

28. A paroxysm of tachycardia occurred in a patient undergoing a dental procedure. Which of the following drugs should be used to relieve it?

29. A 36-year-old female patient who has been limiting the number of foodstuffs in her diet for 3 months presents with a decrease in body weight, deterioration of physical and mental health, face edemata. These changes may be caused by the deficiency of the following nutrients:

30. A 35-year-old female patient has HIV at the AIDS stage. On the skin of the lower extremities and palatine mucosa there appeared rusty red spots, bright red nodules of various sizes One of the nodules was taken for histological study.It revealed a lot of randomly distributed thin-walled vessels lined with endothelium, the bundles of spindle cells containing hemosiderin. What kind of tumor developed in the patient?

31. A patient suffering from stenocardia takes 100 mg of acetylsalicilic acid daily. What is the effect of acetylsalicilic acid in this patient?

32. Examination of an 18-year-old girl revealed the following features: ovarian hypoplasia, broad shoulders, narrow hips, shortening of the lower extremities, webbed neck. Mental development is normal. The patient has been diagnosed with Turner’s syndrome. What chromosomal abnormality does this patient have?

33. A 48-year-old patient has been found to have an increase in the concentration of thyroid hormones in blood. Microscopy of a biopsy sample from the thyroid gland is likely to reveal the following morphological changes affecting the following cells:

34. Bacterioscopy of nasopharyngeal mucus taken from a 2,5-year-old child with nasopharyngitis revealed gram-positive diplococci looking like coffee grains. What organs of the child are most likely to be affected if these microorganisms penetrate the blood?

35. Microscopy of smear preparation stained with methylene blue revealed bacilli with clublike expansions on their ends similar to C.diphteriae. What additional method of staining should be used to verify this assumption?

36. Blood serum of a newborn contains antibodies to measles virus. What kind of immunity is this indicative of?

37. A female with Rh-negative blood of A (II) type has a child with AB(IV) type who has been diagnosed with hemolytic disease resulting from Rh-conflict. What blood type may the baby’s father have?

38. A preparation of endocrine gland demonstrates cortical and medullary substances divided with connective tissue layer. In the cortical substance parenchyma cells make up three zones: they form rounded clusters in the superficial zone, parallel strands in the middle one, and in the deep zone cell strands form net-like structure. What gland is it?

39. Microscopy of a smear obtained from a patient with acute purulent periostitis revealed gram-positive bacteria arranged in clusters resembling bunch of grapes. What microorganisms is this morphology typical for?

40. A severe injury in a 36-year-old patient resulted in a significant blood loss which was accompanied by a blood pressure drop. What hormones provide rapid recovery of blood pressure after the blood loss?

41. Examination of a 27-year-old donor who had not donated blood for a long time revealed HBs antibodies detected by ELISA method. In this case, the positive ELISA results indicate that the donor:

42. A histological specimen represents a structure of the oral cavity, which is formed by bone tissue. It is covered by mucous membrane consisting of keratinizing stratified squamous epithelium. The structure has fatty, glandular and marginal zone. In all parts of the lamina propria the collagen fibers form thick bundles that penetrate deep into the periosteum. What kind of structure is it?

43. Survey radiograph of facial skull of a 16-year-old girl shows some hole-like foci of cranial bone destruction. Histological examination of biopsy material revealed zones of destruction of bone trabeculae, proliferation of connective tissue with diffuse histiocytic infiltrate and a large number of eosinophilic leukocytes. Diagnose the disease:

44. A 46-year-old patient consulted a doctor about pustular rash on the skin of the limbs. What antiseptic should be administered to the patient?

45. Histological specimen of a decalcified tooth represents richly vascularized loose fibrous connective tissue containing a variety of cells. Pyriform odontoblasts of this region are arranged in several rows. What kind of dental structure is it?

46. A dentist examined a 5-year-old boy and found him to have a saddle nose, high-arched palate, natiform skull. Both front maxillary incisors are peg-shaped and have a crescent-shaped notch in the cutting edge. Lymph nodes are not changed. What is the provisional diagnosis?

47. A 32-year-old patient has purulent wound in the lower third of forearm. Smear of purulent wound content has been made. What cells will be generally detected, if it is stained using Romanovsky-Giemsa stain?

48. A 49-year-old mae has mitral stenosis. What is the leading mechanism of heart failure in this case?

49. A 36-year-old patient had had a traumatic brain injury which caused a swallowing impairment. Which part of brain was affected?

50. Microscopy of a dental plaque revealed a large number of cocci arranged in pairs and strings, as well as Gram-positive bacilli which were likely to be the cause of cariogenesis. What microorganism associations are involved in the development of dental caries?

51. Glucose content of blood stays at sufficient level after one week of starvation. Is it caused by activation of the following process:

52. Inhibitory effect of GABA is due to the increased permeability of the postsynaptic membrane for chloride ions. This mediator is produced as a result of decarboxylation of the following amino acid:

53. In a specimen from the ovary stained with hematoxylin-eosin a follicle can be seen. The follicular epithelial cells are arranged in 1-2 layers and have cubic shape, around the oocyte the bright red membrane can be seen. Specify the follicle:

54. A 7-year-old child suffers from acute disease. A pediatrician observed the following during examination: pharynx mucosa is hyperemic, edematous, swollen, cowered with large amount of mucus. Buccal mucosa has whitish discoloured spots. On the next day the child came out in rash with large spots covering the skin of his face, neck and torso. What kind of inflammation causes changes in pharynx mucosa?

55. When processing a molar tooth with a dental cutter the dentist has by accident deeply wounded the patient’s cheek and damaged not only the mucosa but also a muscle. Which muscle was hurt?

56. A patient with a malignant neoplasm on the upper jaw had been administered morphine hydrochloride for analgesia. The injection induced respiratory depression, pupil constriction, cyanosis, hypothermia, loss of consciousness. What antidote must be used?

57. During a surgery, the anesthesiologist used a ganglionic blocker for controlled hypotension. What drug was given the patient in this case?

58. A 5-year-old child with diagnosis of diphtheria has been hospitalised in severe condition in a contagious isolation ward. Tracheostomy had to be performed on the child to prevent asphyxiation. This operation was caried out in the following neck triangle (trigonum):

59. A 48-year-old female patient with a history of cholelithiasis has recurring steatorrhea. What vitamin deficiency may develop as a complication of the current disease?

60. In course of an experiment an animal had its cornea injured. What cells will provide the regeneration of stratified epithelium?

61. Osteolaterism is characterized by a decrease in collagen strength caused by much less intensive formation of cross-links in the collagen fibrils. This phenomenon is caused by hypoactivity of the following enzyme:

62. The operative dentistry department admitted a newborn girl who choked during sucking. Examination revealed cleft palate arising from non-union of the middle frontal process and maxillary process of the I-st branchial arch. The cleft was located in the palate between:

63. During ventricular systole the muscle does not respond to additional stimulation because it is in the phase of:

64. With the purpose of analgesia, a narcotic analgesic has been used with a benzodiazepine drug. What drug has been used to potentiate analgesia?

65. A patient has been preliminarily diagnosed withf paragonimiasis. This disease is caused by lung flukes. The causative agent entered into the patient’s body through:

66. A 60-year-old man with a history of chronic intestinal obstruction has excessive protein putrefaction in the colon. What is the indicator of this process?

67. An animal sensitized with tuberculin had been administered tuberculin intraperitoneally. 24 hours later, during laparotomy, the animal was found to have venous congestion and peritoneal edema. Impression smears from the peritoneum contained a large number of lymphocytes and monocytes. What pathological process was detected in the animal?

68. A female patient has scalded her hand with boiling water. The affected skin area became red, swollen and painful. This effect is caused by accumulation of the following substance:

69. From the fecal sample of a patient Shigella sonnei were isolated. What additional studies are required to identify the source of infection?

70. Patient’s eye accomodation process has been disrupted. What muscle is damaged?

71. A patient has symptoms of atherosclerosis. What plasma lipid transport forms should have an increased concentration?

72. Anatomical dead space is the part of air that remains in the airways after the expiration. Anatomical dead space will be reduced in the following situation:

73. There are several cases of children from boarding school suffering from sore throat. Microscopy of tonsil smears stained according to Neisser method has revealed thin yellow bacilli with dark brown grains on their ends placed in the shape of Roman numeral five. What infection can be suspected in this case?

74. A patient was taken to a hospital with dizziness, dry mouth, mydriatic pupils, accommodation disorder, tachycardia, difficult urination, intestinal atony. These symptoms might have been caused by overdose of the following drug:

75. Analysis of biopsy material of urinary bladder mucosa revealed a tumour of epithelial origin. What kind of epithelium was the source of this tumour?

76. A nuclear power plant disaster fighter had absorbed radiation dose of 5 Gy; in a week he was diagnosed with blood agranulocytosis. What pathogenetic mechanism is principal in its origination?

77. An oncological patient had been administered methotrexate. With time target cells of the tumour lost sensitivity to this drug. At the same time the change in gene expression of the following enzyme is observed:

78. A histological specimen represents the parenchyma composed of lymphoid tissue which forms the diffusely arranged lymph nodules with a central artery. What anatomic formation has the given morphological structure?

79. To perform conduction anesthesia a patient had been administered a drug used in dental surgery. It was followed by the symptoms of poisoning: central nervous system excitation with following paralysis, and acute cardiovascular insufficiency (collapse). Additionally there were allergic reactions (itching, swelling, erythema). Name this drug.

80. A patient with chronic heart failure has been taking digoxin for several months on an outpatient basis. At a certain stage of treatment, he got symptoms of drug overdose. What effect underlies the development of this complication?

81. A patient consulted an immunologist about diarrhea, weight loss within several months, low-grade fever, enlarged lymph nodes. The doctor suspected HIV infection. What immunocompetent cells must be studied in the first place?

82. There is a 7-year-old child with complains of cough, lacrimation, rhinitis, skin rash, photophobia and three-day-long fever as high as 38oC. Physical examination has revealed the following: conjunctivitis; bright red maculopapular rash covering the skin of face, neck and torso; hyperemic pharynx; serous purulent secretions from the nose; dry rales in the lungs. What is the most probable diagnosis?

83. Examination of a 29-year-old patient revealed a dense, immobile, illdefined tumor-like formation in the lower jaw. The overlying mucosa was pale. Biopsy of the neoplasm revealed osteoid structures lined with atypical osteoblasts; numerous pathologic mitotic figures; a great number of thinwalled vessels. What is the most likely diagnosis?

84. A shepherd who has tended sheep together with dogs consulted a doctorabout pain in his right subcostal area, nausea, vomiting. Roentgenoscopy revealed a tumour-like formation. What kind of helminthiasis might be suspected?

85. Microscopy of perianal folds scrape has revealed colourless eggs in the shape of asymmetrical ovals sized 50x23 micrometers. Name the kind of helminth.

86. A patient has sustained a traumatic injury of the greater pectoral muscle. This resulted in a decrease of:

87. A patient complains of decreased abilty to produce proper pressure with his masticatory muscles. What method of study allows checking the patient’s complaint?

87. A patient complains of decreased abilty to produce proper pressure with his masticatory muscles. What method of study allows checking the patient’s complaint?

88. When a wound heals, a scar takes its place. What substance is the main component of its connective tissue?

89. During examination of a 3-monthold infant a pediatrician revealed that the baby’s oral mucosa and tongue were covered with a thick white deposit. In the material taken from the affected site a bacteriologist revealed the presence of yeast fungi giving the reasons for suspecting a fungal infection which occurs most often in children of this age, namely:

90. A 36-year-old patient underwent tooth extraction at a dental clinic. After two weeks the stratified squamous epithelium regenerated at this site. What organelles were involved in the restoration of the mucous membrane?

91. In the experiment, the permeability of cell membrane for potassium ions has been increased. What changes can be expected in the membrane state?

92. A patient with periodontitis has been administered a glucocorticoid drug in form of an ointment. Specify this ointment:

93. Autopsy of a dead 6-year-old child revealed a marked edema of the soft tissues of neck and enlarged tonsils. Pharyngeal mucosa was covered with numerous dense whitish-yellow pellicles exposing deep ulcers after their removal. Histological examination of the pharyngeal mucosa revealed necrosis of the upper epithelial layers, impregnation of the mucous memrane with the fibrinous exudate and moderate leukocyte infiltration. What infectious disease caused the death of the child?

94. When examining a patient with a suspicion of food toxicoinfection, a doctor on duty has detected symptoms characteristic of botulism. The patient named the meals he had eaten the day before. What is the most probable cause of infection?

95. A 40-year-old patient presents with abdominal pain, frequent loose stools with mucus and blood. Stool analysis revealed vegetative forms of some protozoa sized 30-40 microns, with short pseudopodia, containing large amounts of phagocytosed erythrocytes. What protozoan disease does the patient have?

96. After the sanitary and bacteriological study of tap water the following results were obtained: the total number of bacteria in 1,0 ml was 80, coli index was 3. How would you interpret the study results?

97. Experimental stimulation of the peripheral segment of the vagus nerve of a cat will result in the following changes:

98. On the base of the clinical data a child was diagnosed with atypical pneumonia resistant to the effects of beta-lactam antibiotics. The patient’s sputum was cultured and incubated in a special medium, which resulted in growth of microorganisms forming microscopic colonies with a dense center (looking like fried eggs). What microorganism caused the disease?

99. During an abdominal surgery a 46-year-old patient working at a meat processing plant was found to have a very dense roundish formation 11 cm in diameter which was localized in the right lobe of the liver. The cross-section of the formation has a porous appearance due to a large number of small vesicles with layers of dense connective tissue. The surrounding tissues have visible necrotic areas and proliferation of granulation tissue including many eosinophils and foreign body giant cells. What disease can be thought of in this case?

100. A patient with arthritis and varicose veins has been taking a nonsteroidal antiinflammatory drug for a long time, which caused the thrombosis of cutaneous veins. Which of the listed drugs might have caused this complication?

101. The patient’s condition after blood transfusion has been aggravated by posttransfusion shock. Name the type of allergic reaction causing this pathology.

102. A 26-year-old patient was found to have a big furuncle of soft tissues of face by the root of nose and inferior eyelid. This disease can be seriously complicated by the infection spreading along veins of this region to the sinuses of dura brain mater. What sinus is most likely to be affected?

103. A patient has secretory dysfunction of the submandibular salivary galnd. Which nerve is responsible for its vegetative innervation?