Іноземна мова

The patient’s examination in a hospitals pecialised in diseases of nervous system hasr evealed absence of light-induced miosis. It isc aused by the damage of the following brains tructures:

A specimen presents an endocrine system

organ covered with capsule made of connective

tissue. Septa branch off from the capsule

inwards and divide the organ into lobules. Each

lobule consists of two cell types: neurosecretory

pinealocytes (polygonal cells with processes)

located in the center and gliacytes (astrocytes)

located at the periphery. What organ is

represented in this specimen?

Alcoholic intoxication is accompanied by

disturbed motor coordination and equilibrium

due to the damage caused to structural elements

of the cerebellum. Functional disturbance of the

following cells occurs in the first place:

Carious cavities of a 29-year-old patient

contain parasitic protozoa. It is established that

they belong to the Sarcodina class. Specify these

protozoa:

A patient presents with dysfunction of the

cerebral cortex accompanied by epileptic

seizures. He has been administered a biogenic

amine synthetized from glutamate and

responsible for central inhibition. What

substance is it?

What factor results in the highest energy

expenditure under the normal vital activity

conditions?

In the process of embryogenesis of

dentomaxillary system there was an enamel

disturbance detected. What source of tooth

development is damaged in this case?

During teeth examination on the lateral

surface of the first upper molar there was

detected a cone-shaped carious cavity with base

oriented towards the tooth surface and apex -

towards the tooth center. Softened dentin is

visible at the floor of the carious cavity. Make

the diagnosis:

Bacilli were extracted from the

investigated sample. The bacilli are curved,

extremely mobile, gramnegative, form no spores

or capsules, have anaerobic form of respiration.

They form transparent smooth colonies in

alkaline agar, ferment saccharose and mannose

into acid, produce exotoxin, fibrinolysin,

collagenase, and hyaluronidase. What agent was

extracted?

Examination of a patient revealedg lycosuria and hyperglycemia. He complains of dry mouth, itchy skin, frequent urination, thirst. He has been diagnosed with diabetes mellitus. What is the cause of polyuria in this patient?

The autopsy of the body of a man, who

suffered from toxic diphtheria and died on the 9 th day from the onset of disease with signs of cardiac decompensation, has revealed the following: dilated cardiac cavities, dull flaccid myocardium, myocardial section is variegated. Microscopy revealed fatty degeneration of cardiac hystiocytes, large foci of myocytolysis, stromal edema with scant lymphocytic and macrophageal infiltration. Specify the type of myocarditis in this case:

A 33-year-old man has a cystic growth

connected to the 2nd molar of the lower jaw.

Within the cystic cavity there is a rudimentary

tooth. On microscopy: inner cystic surface is

covered with stratified squamous epithelium,

there are groups of mucin-producing cells. What

diagnosis is the most likely?

In dental practice atropine sulfate is used

to decrease salivation. This drug belongs to the

following group:

A doctor has made a diagnosis of

gingivitis and recommended the patient to rinse

the oral cavity with an oxidizing agent. Specify

this agent:

Roentgenologically confirmed

obstruction of common bile duct resulted in

preventing bile from inflowing to the duodenum.

What process is likely to be disturbed?

A specimen of intestine demonstrates

complex branching tubuloalveolar glands with their ends embedded in the submucous layer.

What organ is it?

A 50-year-old man came to a hospital

with complaints of memory disorders, painful

sensations along the nerve trunks, decreased

mental ability, circulatory disorders and

dyspepsia. Anamnesis states excessive alcohol

consumption. What vitamin deficiency can

result in such symptoms?

A connective tissue specimen stained

with hematoxylin-eosin shows isogenous cell

groups surrounded with basophilic intercellular

substance. No fibrous structures are detected.

What type of connective tissue is it?

An accident had resulted in a

65-year-old man drowning in a lake.

Resuscitation measures allowed to restore his

respiration and cardiac function. What factor

prolongs the period of apparent death?

A 47-year-old man consulted a dentist

about difficult mouth opening (trismus). The patient has a history of a stab wound of the lower

extremity. What infection can be manifested by

these symptoms?

A patient is diagnosed with deformed

posterior portion of the nasal septum. What bone

is deformed?

Gastroscopy of a patient revealed the

lack of mucus in the coating of the mucous

membrane. This can be caused by the

dysfunction of the following cells of gastric

wall:

On microscopic examination of a

surgical biopsy material (part of the lip with an

ulcer) near the ulcer margins and under the ulcer

floor in the connective tissue of mucosa there are

epithelial complexes composed of atypical

stratified epithelium with pathological mitotic

figures. Within these complexes there are

accumulations of bright pink concentric

formations. What pathology is it?

During an experiment aimed as study of respiration regulation processes the peripheral

chemoreceptors of test animals were stimulated,

which resulted in changed respiratory rate and

depth. Where are these receptors localized?

A patient suffers from disturbed blood

supply of superior lateral surface of the cerebral

hemispheres. What blood vessel is damaged?

Electron diffraction pattern of a

spermatozoon clearly presents a sheathlike

structure localized in the spermiocalyptrotheca

and participating in dissolution of ovular

membranes. Name this structure:

According to the law of constancy of

chromosome numbers, most animal species

have definite and constant chromosome number.

The mechanism that maintains this constancy

during sexual reproduction of organisms is

called:

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?

Cytogenetic analysis allowed to

determine the patient’s karyotype - 47, XY,

+21/46, XY. Name this condition:

To prevent wound infection associated

with surgical procedures a patient was given a

synthetic antiprotozoan drug demonstrating high

activity against Helicobacter pylori. Specify this

drug:

A patient suffers from diabetes mellitus

with fasting hyperglycemia over 7,2 mmol/l.

What blood plasma protein would allow to

assess the patient’s glycemia level

retrospectively (4-8 weeks prior to

examination)?

A doctor has established significant

growth retardation, disproportional body build,

and mental deficiency of a child. What is the

most likely cause of this pathology?

A patient with symptoms of acute heart

failure, namely pallor, acrocyanosis, and rapid

shallow breathing, has been delivered to an

emergency department. Which of these drugs is

indicated in this case?

Cytochemical investigation revealed

high content of hydrolytic enzymes in the

cytoplasm. This phenomenon indicates the

activity of the following organelles:

A patient diagnosed with botulism has

been prescribed antibotulinic serum for

treatment. What immunity will be formed in the

given patient?

The patient’s saliva has been tested for

antibacterial activity. What saliva component

has antibacterial properties?

A schizophrenic patient has been

prescribed aminazine. What pharmacodynamic

action of this drug justifies its prescription in this

case?

During examination of a woman she was

found to have a luminal narrowing of the right

jugular foramen (foramen jugulare). What

cranial bones form this foramen?

Histologic specimen demonstrates an

oral cavity organ with mucosa covered with

keratinized stratified squamous epithelium.

Specify this organ or its part:

A patient with a nasal trauma presents

with skull fracture that circles the piriform

opening. What bone is damaged?

One of the coats of a hollow organ has

anastomotic fibers with nuclei. The fibers

consist of cells that form intercalated disks at the

places of contact. What tissue forms this coat?

A patient has developed a grayish-white

dense protruding focus on the oral mucosa.

Histologycally there are hyperkeratosis,

parakeratosis, and acanthosis of epithelium with

lymphocytic and plasmocytic infiltration of

underlaying connective tissue in this area. What

pathology has developed in the oral mucosa?

On microscopic examination of

leftovers of the canned meat eaten by a patient

with severe food toxicoinfection the following

was detected: grampositive bacilli with

subterminal staining defect and configuration

alteration of bacilli generally resembling a

tennis racket. What agent was detected?

A patient with glossitis presents with

disappearance of lingual papillae, reddening and

burning pain in the tongue. Blood test:

erythrocytes 2,2 · 1 01 2/l, hemoglobin - 103 g/l,

color index - 1,4. What type of anemia is it?

A patient with autoimmune thyroiditis

has been prescribed a peptide hormonal agent.

Specify this agent:

A worker of a cattle farm consulted a

surgeon about fever up to 4 0

oC, headache,

weakness. Objective examination of his back

revealed hyperemia and a dark red infiltration up

to 5 cm in diameter with black bottom in its

center, which was surrounded with pustules.

What disease are these presentations typical of?

A 33-year-old man presents with

disturbed pain and thermal sensitivity after a

spinal cord trauma. The following ascending

tract is injured:

In Western Europe nearly half of all

congenital malformations occur in the children

conceived in the period when pesticides were

used extensively in the region. These congenital

conditions are the result of the following factor:

Microscopy of an oval cell, 150 micron

in size, revealed the following: cytoplasm has

yolk inclusions but no centrioles. Name this cell:

A patient has been hospitalised with

provisional diagnosis of diphyllobothriasis.

What food products can be the cause of this

condition?

A patient has undergone recurring blood

tests that revealed sharp fluctuations of glucose

content: significant increase in absorptive state

and significant decrease in postabsorptive state.

What pathology can be the cause of it?

A 24-year-old patient has been

administered glutamic acid to treat epilepsy.

Medicinal effect in this case occurs not due to

glutamate itself, but due to the product of its

decarboxylation:

Histological investigation of renal

biopsy material taken from a patient with

tuberculosis has revealed chaotically located

chromatin granules in the focus of caseous

necrosis. These changes are the result of:

Enzymes and other active substances

regulating connective tissue density and

permeability are being produced in connective

tissue cells. What enzyme drug is used to make

the connective tissue growths looser and more

permeable?

Microscopic examination of pus sample

taken from mandibular fistula canal and stained

by Gram’s method has revealed druses with

gram-positive coloring in the center and

cone-shaped structures with gram-negative

coloring. Such morphology is characteristic of

the agent of:

At a certain stage of human ontogenesis,

physiological bond occurs between circulatory

systems of the mother and the fetus. This

function is being carried out by the following

provisory organ:

Autopsy of a 58-year-old man, who had

been suffering from rheumatic heart disease and

died of cardiopulmonary decompensation,

revealed gray diffuse film- and fiber-shaped

coating in his pericardium. What type of

inflammation is characteristic of this

pericarditis?

A newborn boy has been diagnosed with

hydrocephalus. Doctors consider it to be caused

by teratogenic factors. What germ layers are

affected by the teratogen?

There is increased activity of AST, LDH

1 , LDH 2 , and CPK in the patient’s blood.

Pathological process most likely occurs in the:

Due to overdosage of a vasodilator a

58-year-old patient has developed acute vascular

insufficiency. What drug would be advisable for

termination of this pathological condition?

Deaf parents with genotypes DDee and

ddEE gave birth to a girl with normal hearing.

Specify the form of D and E genes interaction:

A patient is diagnosed with pancreatitis.Starch decomposition disturbance occurs in the

patient’s intestine due to deficiency of the

following pancreatic enzyme:

Autosomal nondisjunction had occurred

in a woman during meiosis. An ovum with the

third copy of the 18th chromosome was formed.

The ovum was impregnated by normal

spermatozoon. The resulting child will suffer

from:

During tooth brushing it is not

uncommon for oral mucosa to be injured.

However, bleeding quickly stops on its own.

What substances in saliva quickly staunch the

flow of blood during minor oral injuries?

Amino acids join to each other in

ribosomes of granular endoplasmic reticulum.

Knowing the sequence of amino acids and

applying genetic code, it is possible to determine

the sequence of nucleoids in:

An oculist has detected increased time of darkness adaptation of a patient’s eye. What

vitamin deficiency can cause such symptom?

During examination of the oral cavity at

the vestibular surface of the lower right incisor

there was detected a rounded growth on the thin

pedicle. Histologically: in the connective tissue

there are numerous thin-walled sinusoids,

hemorrhage areas, hemosiderin foci, and giant

cells resembling osteoclasts. Make the

diagnosis:

A 35-year-old woman is diagnosed with

faucial diphtheria. The patient died with signs of

acute heart failure. On autopsy: heart cavities are

enlarged in the diameter, heart muscle is dull,

flaccid, striped on section, with yellowish areas

under the endocardium. What type of

degeneration was detected in cardiac

hystiocytes?

A patient with displaced fracture of the

right coronoid process of mandible has been

delivered to a first-aid center. What muscle had

displaced the coronoid process?

A 40-year-old patient suffers from

intolerance of dairy products. This condition has

likely developed due to insufficiency of the

following digestive enzyme:

A patient presents with

lymphocytic-monocytic leukogram pattern. It is

characteristic of:

A patient has a history of chronic heart

failure. Which of the following hemodynamic

parameters is a major symptom of cardiac

decompensation development?

A 45-year-old patient with essential

hypertension, who has been taking an

antihypertensive drug for 4 days, notes that his

blood pressure is normalized; however the

patient complains of sleepiness and

sluggishness. What drug is the patient taking?

A patient suffering from malaria has

developed hemolytic anemia after taking

primaquine antimalarial drug. Hereditary insufficiency of the following enzyme in

erythrocytes will be observed in this case:

A 55-year-old man with acute heart

failure has been administered a quickrelief

cardiac glycoside. Which of the following drugs

has been given to the patient?

To perform conduction anesthesia a

patient had been administered a drug used in

dental surgery. The patient developed the

symptoms of poisoning: central nervous system

excitation followed by paralysis and acute

cardiovascular insufficiency (collapse).

Additionally there were allergic reactions

(itching, swelling, erythema). Name this drug:

Premature babies often develop

respiratory distress syndrome. This pathology is

caused by the deficiency of a certain component

of the blood–air barrier. Name this component:

A victim of an accident has hemorrhage

in the area of lateral surface of the mastoid process. What branch of the external carotid

artery supplies this area with blood?

After anaesthetic application during

tooth extraction the patient developed marked

soft tissue edema of the upper and lower jaw,

skin rash on the face, reddening, and itching.

What pathological process results in such

reaction to the anaesthetic?

What coenzyme of flavin-dependent

dehydrogenases participates in the reactions of

tricarboxylic acid cycle?

Autopsy of a 45-year-old man revealed

the following: wrinkled shagreen-resembling

intima in the ascending aorta; elastic staining is

negative. Wall of the left ventricle is up to 1,5

cm in width; no myocardial alterations. Specify

the most probable disease of the aorta:

High-altitude dwellers typically

demonstrate chronically intensified respiration

and decreased pCO2 value of blood. What mechanism is leading in the compensation of

their asid-base imbalance?

In the armpits of a patient there are small

(1-1,5 mm), dorsoventrally flattened, wingless,

blood-sucking insects. Their larvae have been

developing in the armpits as well. What disease

is caused by these insects?

A patient has developed a painful sore

with soft ragged edges in the oral cavity.

Microscopically there is lymphocytic infiltration

with epithelioid and giant multinucleate

Langhans cells in the sore floor. What diagnosis

is the most likely?

Red bone marrow has been damaged

under radioactive emission of 5 Gy. What

determines the red bone marrow sensitivity

towards ionizing radiation?

The autopsy of a 45-year-old man, who

worked in organic acids production and died

from uremia, has revealed reduced and completely destroyed crowns of the upper and

lower incisors. Microscopy detects destruction

of dentin and enamel, the pulp is covered with

dense replacing dentin. What pathological

process occurred in the teeth in this case?

To assess the rate of collagen

disintegration during certain connective tissue

disturbances, it is necessary to measure the urine

content of the following:

A 30-year-old man with

glomerulonephritis has developed nephrotic

syndrome. What symptom invariably

accompanies nephrotic syndrome?

After examining a patient a doctor

recommended him to exclude rich meat and

vegetable broths, spices, and smoked products

from the diet, since the patient was found to

have:

A patient with maxillofacial joint arthritis has come to a dentist. The dentist

prescribed an

ointment with an

antiinflammatory agent that is a pyrazolone

derivative. Name this agent:

Chronic overdosage of glucocorticoids

leads to the development of hyperglycemia.

What process of carbohydrate metabolism is

responsible for this effect?

A puncture sample has been taken from

the inguinal lymph nodes of a patient

provisionally diagnosed with plague. The

sample was inoculated into hard nutrient

medium. What shape will the colonies have, if

the diagnosis is confirmed?

In the course of an experiment

researchers stimulate a branch of the

sympathetic nerve that innervates heart. What

alterations of cardiac activity should be

registered?

A 19-year-old young man has been

examined in a nephrological hospital. Increased potassium content was detected in secondary

urine of the patient. Such alterations are the most

likely to be caused by the increased secretion of

the following hormone:

A forensic laboratory received clothes

of a citizen, who a day before was reported

missing. The clothes were found in a shed, there

are red stains identified as blood by an expert.

What reaction should be performed to determine

whether these red stains are dried human blood?

A patient with chronic renal failure

presents with reduced inulin clearance of 60

ml/min. The following renal function is

disturbed:

A man came to a surgeon with

complains of pain in his lower right abdomen.

On deep palpation the doctor detected a painful

area in the right inguinal region. What part of the

intestine is the most likely to be affected with

pathological process?

For biochemical diagnostics of cardiac

infarction it is necessary to determine activity of

a number of enzymes and their izoenzymes in

the blood. What enzyme assay is considered to

be optimal for confirming or ruling out cardiac

infarction at the early stage, after the patient

develops thoracic pain?

A patient with bronchial asthma has

developed a bronchial spasm during the visit to a

dentist. Name the drug necessary to arrest the

spasm:

A patient has been diagnosed with

severe B12-deficient anemia with hemopoiesis

disturbance. Anamnesis states total gastrectomy.

What cells allow to confirm this diagnosis, if

they are absent in the peripheral blood?