Which of the listed diuretic agents WILL

E.

+

35. Live vaccine was injected into the

human body. Increasing activity of what

connective tissue cells can be expected?

A. Plasmocytes and lymphocytes

B. Macrophages and fibroblasts

C. Pigmentocytes and pericytes

D. Adipocytes and adventitious cells

E. Fibroblasts and labrocytes

36. When a patient with traumatic impairment

of the brain was examined, it was

discovered that he had stopped to distinguish

displacement of an object on

the skin. What part of the brain was

damaged?

A. Posterior central gurus

B. Occipital zone of the cortex

C. Parietal zone of the cortex

D. Frontal central gurus

E. Frontal zone

37. In the blood of a 26-year-old man

18%of erythrocytes of the spherical, ballshaped,

flat and spinous shape have been

revealed. Other eritrocytes were in form

of the concavo-concave disks. How is this

phenomenon called?

Krok 1 Medicine 2006 5

A. Physiological poikilocytosis

B. Pathological poikilocytosis

C. Physiological anisocytosis

D. Pathological anisocytosis

E. Erytrocytosis

38. A 10-year-old girl often experiences

acute respiratory infections with multiple

punctate haemorrages in the places of

clothes friction. Hypovitaminosis of what

vitamin has the girl?

A. _

B. _6

C. _1

D. _

E. _2

39. Different functional groups can be

presented in the structure of L-amino acid’s

radicals. Identify the group that is able

to form ester bond:

A. −OH

B. −SH

C. −CONH 2

D. −CH 3

E. −NH 2

40. Moving of the daughter chromatids to

the poles of the cell is observed in the mitotically

dividing cell. At what stage of the

mitotic cycle is this cell?

A. Anaphase

B. Metaphase

C. Telophase

D. Prophase

E. Interphase

41. During examination of a patient,

there was found a neoplasm in the white

substance of cerebral hemispheres with

localization in the knee and frontal part

of posterior crus of internal capsule. Fibres

of what conductive tract of the brain

will be disrupted?

A. Tr. pyramidalis

B. Tr. frontothalamicus

C. r. thalamocorticalis

D. Tr. frontopontinus

E. Tr. parietooccipitopontinus

42. A patient with diabetes mellitus has

been delivered in hospital in the state of

unconsciousness. Arterial pressure is low.

The patient has acidosis. Point substances,

which accumulation in the blood results in

these manifestations:

A. Ketone bodies

B. Amino acids

C. Monosaccharides

D. High fatty acids

E. Cholesterol esters

43. A person has steady HR not exceeding

40 bpm. What is the pacemaker of this

person’s heart rhythm?

A. Atrioventricular node

B. Sinoatrial node

C. His’ bundle

D. Branches of His’ bundle

E. Purkinje’s fibers

44. A doctor administered Allopurinol

to a 26-year-old young man with the

symptoms of gout. What pharmacological

action of Allopurinol ensures therapeutical

effect?

A. By inhibiting uric acid synthesis

B. By increasing uric acid excretion

C. By inhibiting leucocyte migration into

the joint

D. By general anti-inflammatory effect

E. By general analgetic effect

45. A patient who came to the doctor

because of his infertility was administered

to make tests for toxoplasmosis

and chronic gonorrhoea. Which reaction

should be performed to reveal latent

toxoplasmosis and chronic gonorrhoea of

the patient?

A. (R)CFT- Reiter’s complement fixation

test

B. IFA - Immunofluorescence assay

C. Immunoblot analysis

D. RDHA - Reverse direct hemagglutination

assay

E. RIHA - Reverse indirect hemagglutination

assay

46. Under some diseases it is

observed aldosteronism accompanied by

hypertension and edema due to sodium

retention in the organism. What organ of

the internal secretion is affected under

aldosteronism?

A. Adrenal glands

B. Testicle

C. Ovaries

D. Pancreas

E. Hypophysis

47. A patient had been taking glucocorticoids

for a long time. When the

preparation was withdrawn he developed

the symptoms of disease aggravation,

Krok 1 Medicine 2006 6

decreased blood pressure and weakness.

What is the reason of this condition?

A. Appearance of adrenal insufficiency

B. Hyperproduction of ACTH

C. Sensibilization

D. Habituation

E. Cumulation

48. A patient has tissue ischemia below

the knee joint accompanied with intermittent

claudication. What artery occlusion

should be suspected?

A. Popliteal artery

B. Peroneal artery

C. Posterior tibial artery

D. Anterior tibial artery

E. Proximal part of femoral artery

49. An experiment proved that UVradiated

cells of patients with xeroderma

pigmentosum restore the native DNA

structure slower than cells of healthy

individuals as a result of reparation

enzyme defection. What enzyme helps

this process?

A. Endonuclease

B. RNA ligase

C. Primase

D. DNA polymerase III

E. DNA gyirase

50. A patient, who suffers from congenital

erythropoietic porphyria, has skin

photosensitivity. The accumulation of

what compound in the skin cells can cause

it?

A. Uroporphyrinogen 1

B. Protoporphyrin

C. Uroporphyrinogen 2

D. Coproporphyrinogen 3

E. Heme

51. A sick man with high temperature and

a lot of tiny wounds on the body has been

admitted to the hospital. Lice have been

found in the folds of his clothing. What

disease can be suspected?

A. Epidemic typhus

B. Tularemia

C. Scabies

D. Malaria

E. Plague

52. A patient with suspicion on epidemic

typhus was admitted to the hospital. Some

arachnids and insects have been found in

his flat.Which of them may be a carrier of

the pathogen of epidemic typhus?

A. Lice

B. Spiders

C. Bed-bugs

D. Cockroaches

E. Houseflies

53. A businessman came to India from

South America. On examination the

physician found that the patient was

suffering from sleeping-sickness. What

was the way of invasion?

A. As a result of bug’s bites

B. As a result of mosquito’s bites

C. With contaminated fruits and vegetables

D. Through dirty hands

E. After contact with sick dogs

54. Patients with bile ducts obstruction

suffer from inhibition of blood coagulation,

bleedings as a result of low level of

vitamin assimilation. What vitamin is in

deficiency?

A. К

B. А

C. D

D. Е

E. Carotene

55. Blood analysis of a patient showed signs

ofHIVinfection (human immunodeficiency

virus). Which cells does HIV-virus

primarily affect?

A. Cells that contain receptor T4 (Thelpers)

B. Cells that contain receptor IgM (Blymphocytes)

C. Specialized nervous cells (neurons)

D. Mast cells

E. Proliferating cells (stem hematoplastic

cells)

56. The preventive radioprotector was

given to a worker of a nuclear power

station. What mechanism from the below

mentioned is considered to be the main

mechanism of radioprotection?

A. Inhibition of free radicals formation

B. Prevention of tissue’s hypoxia

C. Activation of oxidation reactions

D. Increasing of tissue blood supply

E. Increasing of respiration

57. The pulmonalis embolism has

suddenly developed in a 40-year-old patient

with opened fracture of the hip.

Choose the possible kind of embolism:

Krok 1 Medicine 2006 7

A. Fat

B. Thrombus-embolus

C. Air

D. Tissue

E. Foreign body

58. A patient’s blood was analyzed and

the decreased erythrocyte’s sedimentation

rate (ESR) was discovered. What disease

from the listed below is accompanied with

decreased ESR?

A. Polycytemia

B. Hepatitis

C. Splenomegaly

D. Vitamin B deficiency

E. Myocardial infarction

59. A 46-year-old patient has complained

of headache, fatigue, thirst, pains

in the spine and joints for the last 2

years. Clinically observed disproportional

enlargement of hands, feet, nose, superciliary

arches. He notes that he needed

to buy bigger shoes three times. What

is the main reason of such disproportional

enlargement of different parts of the

body?

A. Cartilaginous tissue proliferation under

growth hormone influence

B. Increased sensitivity of the tissues to

growth hormone

C. Joints dystrophy development

D. Increased sensitivity of the tissues to

insulin

E. Joints chronic inflammation

development

60. A mother of a newborn complains

of her baby’s constant belching with

undigested milk. Which developmental

anomaly is it an evidence of?

A. Esophageal atresia

B. Labium leporium

C. Faux lupinum

D. Anal atresia

E. Esophageal fistula

61. During the endoscopy the inflammation

of a major papilla of the duodenum

and the disturbances of bile secretion

were found. In which part of duodenum

were the problems found?

A. Descendent part

B. Ascendant part

C. Bulb

D. Upper horizontal part

E. Lower horizontal part

62. An 18-year-old patient came to the

out-patient department with the complaints

of bleeding trauma in the vestibule of

his nose. On examination: the mechanical

injury of the mucous layer of the vestibule

without continuation into nasal cavity

proper. What is the boundary between

the vestibule and nasal cavity proper?

A. Nasal limen

B. Nasal roller

C. Nasal septa

D. Choanes

E. Nostrils

63. A 50-year-old patient was injured

on the occipital region of the head. The

closed skull trauma was diagnosed. She

was taken to the hospital. The medical

examination: deregulation of walking and

balance, trembling of arms. What part of

brain was injured?

A. The cerebellum

B. The medulla oblongata

C. The mind-brain

D. The inter-brain

E. The spinal cord

64. A patient with complaints of dryness

in the mouth, photophobia and vision

impairment was admitted to the

reception-room. Skin is hyperemic, dry,

pupils are dilated, tachycardia. Poisoning

with belladonna alkaloids was diagnosed

on further examination. What medicine

should be prescribed?

A. Prozerin

B. Diazepam

C. Pilocarpine

D. Armine

E. Dipiroxim

65. Autopsy revealed that right lung is

enlarged, solid, there are fibrin layers on

the pleura. Lung tissue is light grey color

on incision with muddy liqued exudates.

What lung disease are these symptoms

typical for?

A. Croupous pneumonia

B. Bronchopneumonia

C. Interstitial pneumonia

D. Pulmonary gangrene

E. Fibrosing alveolitis

66. During the operation on the hip joint

of a 5-year-old child her ligament was

damaged which caused bleeding.What ligament

was damaged?

Krok 1 Medicine 2006 8

A. The head of the thigh

B. Perpendicular of the acetabule

C. Iliofemoral

D. Pubofemoral

E. Ischiofemoral

67. On autopsy it was revealed: pia mater

of the upper parts of cerebral hemisphere

is plethoric, of yellowish-green color,

soaked with purulent and fibrose exudate,

looks like a cap. What disease is it typical

for?

A. Meningococcal meningitis

B. Tuberculous meningitis

C. Grippal meningitis

D. Meningitis connected with anthrax

E. Meningitis connected with typhus

68. A 55-year-old patient with continuing

ventricular arrhythmias was admitted to

the hospital. The patient is taking timolol

drops for glaucoma, daily insulin injections

for diabetes mellitus, and an ACE

inhibitor for hypertension. You have decided

to use phenytoin instead of procainamide.

What is the reason?

A. The anticholinergic effect of procainamide

would aggravate glaucoma

B. The local anesthetic effect of procainamide

would potentiate diabetes

C. The hypertensive effects of procainamide

would aggravate the hypertension

D. The local anesthetic effect of procainamide

would aggravate the hypertension

E. The cholinergic effects of procainamide

would aggravate the diabetes

69. A 35-year-old man under the

treatment for pulmonary tuberculosis has

acute pain onset of right big toe, swelling,

and low-grade fever. The gouty arthritis

was diagnosed and high serum uric acid

level was found. Which of the following

antituberculous drugs are known for

causing high uric acid levels?

A. Pyrazinamide

B. Cycloserine

C. Thiacetazone

D. Rifampicin

E. Aminosalicylic acid

70. A person was selling "homemade

pork"sausages at the market. State sanitary

inspector suspected falcification of

the sausages. What serological immune

reaction can identifiy food substance?

A. Precipitation test

B. Indirect hemagglutination test

C. Agglutination test

D. Immunofluorescence test

E. Complement-fixation test

71. A patient with rheumatoid arthritis

who had been treated with indometacin

has got signs of gastropathy. What activity

of the drug can this complication be

connected with?

A. Anticyclooxygenase

B. Antiserotonin

C. Antihistamine

D. Antikinine

E. Locally irritating

72. A 25-year-old woman with red and

itchy eczematoid dermatitis visits your

office. She had a dental procedure one

day earlier with administration of a local

anesthetic. There were no other findings,

although she indicated that she had a history

of allergic reactions. Which of the

following drugs is most likely involved?

A. Procaine

B. Cocaine

C. Lidocaine

D. Bupivacaine

E. Etidocaine

73. In course of metabolic process active

forms of oxygen including superoxide anion

radical are formed in the human body.

By means of what enzyme is this anion

inactivated?

A. Superoxide dismutase

B. Catalase

C. Peroxidase

D. Glutathioneperoxidase

E. Glutathionereductase

74. A patient has elbow joint trauma

with avulsion of medial epicondyle of

humerus. What nerve can be damaged in

this trauma?

A. Ulnar

B. Radial

C. Musculocutaneous nerve

D. Cardiac cutaneous nerve

E. Medial cutaneous nerve of forearm

75. A student is writing a thorough

summary of a lecture.Quality of summarizing

has considerably worsened when his

neighbours started talking. What kind of

inhibition in the cerebral cortex caused

this effect?

Krok 1 Medicine 2006 9

A. External

B. Protective

C. Fading

D. Differentiated

E. Delayed

76. While enrolling a child to school

Mantu’s test was made to define whether

revaccination was needed. The test result

is negative. What does this test result

mean?

A. Absence of cell immunity to the

tuberculosis

B. Presence of cell immunity to the

tuberculosis

C. Absence of antibodies for tubercle

bacillus

D. Absence of antitoxic immunity to the

tuberculosis

E. Presence of antibodies for tubercle

bacillus

77. The donor who didn’t donate the blood

for a long time was investigated with

IFA method. Anti-HBs antibodies were

revealed.What does positive result of IFA

in this case mean?

A. Previous hepatitis B

B. Acute hepatitis B

C. Acute hepatitis C

D. Chronic hepatitis В

E. Chronic hepatitis С

78. Testosterone and it’s analogs increase

the mass of skeletal muscles that allows to

use them for treatment of dystrophy. Due

to interaction of the hormone with what

cell substrate is this action caused?

A. Nuclear receptors

B. Membrane receptors

C. Ribosomes

D. Chromatin

E. Proteins-activators of transcription

79. Inhibition of α -motoneuron of the

extensor muscles was noticed after stimulation

of α -motoneuron of the flexor

muscles during the experiment on the spinal

cord. What type of inhibition is this

process based upon?

A. Reciprocal

B. Presynaptic

C. Depolarizational

D. Recurrent

E. Lateral

80. A patient who has been strictly keeping

to a certain diet for 10 days went

through examination of respiratory coefficient.

It was determined that it was equal

1.What have the patient been keeping to?

A. With domination of carbohydrates

B. With domination of proteins and fat

C. With domination of fat and

carbohydrates

D. Mixed

E. With domination of proteins and

carbohydrates

81. Buffer capacity of a worker’s blood

was decreased due to exhausting muscular

work. By coming of what acid substance

in the blood can this state be explained?

A. Lactate

B. Pyruvate

C. 1,3-bisphosphoglycerate

D. α -ketoglutarate

E. 3-phosphoglycerate

82. Examination of initial molecular

structure revealed substitution of the

glutamic acid by valine. What inherited

pathology is it typical for?

A. Sickle-cell anemia

B. Thalassemia

C. Minkowsky-Shauffard disease

D. Favism

E. Hemoglobinosis

83. Inflamation is characterised by

increased permeability of vessels of microcirculation

stream, increase of their

hydrodynamic blood pressure. Increasing

of the osmotic concentration and dispersity

of protein structures is present in the

intercellular fluid. What kind of edema

will appear in this case?

A. Mixed

B. Hydrodynamic

C. Colloid-osmotic

D. Lymphogenic

E. Membranogenic

84. Increased fragility of vessels, enamel

and dentine destruction resulting from

scurvy are caused by disorder of collagen

maturation. What stage of procollagen

modification is disturbed under this avitaminosis?

A. Hydroxylation of proline

B. Formation of polypeptide chains

C. Glycosylation of hydroxylysine residues

D. Removal of C-ended peptide from

procollagen

E. Detaching of N-ended peptide

85. Scraps of the mycelium of a fungus,

Krok 1 Medicine 2006 10

spores, air bubbles and fat drops were discovered

on microscopy of the patient’s

hair excluded from the infected areas.

What fungus disease is characterised by

this microscopic picture?

A. Favus

B. Microspory

C. Trichophytosis

D. Epidermophytosis

E. Sporotrichosis

86. On autopsy of the 58-year-old man it

was revealed: mitral valve is deformed,

thickened, not totally closed. Microscopically:

foci of collagen fibers are eosinophilic,

have positive fibrin reaction. The most

likely it is:

A. Fibrinoid swelling

B. Fibrinoid inflammation

C. Mucoid swelling

D. Hyalinosis

E. Amyloidosis

87. Hypertrychosis of auricles is caused by

a gene that is localized in Y-chromosome.

Father has this feature. What is the

probability to give birth to a boy with such

anomaly?

A. 100%

B. 0%

C. 25%

D. 35%

E. 75%

88. A54-year-old man was admitted to the

hospital with complaints of pain in the right

subcostal region, vomiting with blood.

Objectively: enlarged liver, varicose veins

in the stomach and esophagus. Disfunction

of what vessel is likely to have taken

place?

A. V ena porta

B. Aorta abdominalis

C. V ena hepatica

D. V ena cava superior

E. V ena cava inferior

89. A 37-year-old man was admitted

to the surgical department with the

symptoms of acute pancreatitis: vomiting,

diarrhea, bradycardia, hypotention,

weakness, dehydration of the organism.

What medicine should be used first of all?

A. Contrycal

B. No-spa

C. Platyphylline

D. Etaperazine

E. Ephedrine

90. A person has reduced diuresis,

hypernatremia, hypokalemia.

Hypersecretion of what hormone can

cause such changes?

A. Aldosterone

B. Vasopressin

C. Auricular sodiumuretic factor

D. Adrenalin

E. Parathormone

91. Microspecimen of red bone marrow

contains multiple capillares through

the walls of which mature blood cells

penetrate into the bloodstream. What

type of capillares are these?

A. Sinusoidal

B. Fenestrational

C. Somatical

D. Visceral

E. Lymphatic

92. A 57-year-old patient was admitted

to the gastroenterological department with

suspicion of Zollinger-Ellison syndrom

because of rapid increase of gastrin level

in the blood serum. What is the most

probable disorder of the secretory function

of stomach?

A. Hyperacidic hypersecretion

B. Hyperacidic hyposecretion

C. Achylia

D. Hypoacidic hyposecretion

E. Hypoacidic hypersecretion

93. For a long time a 49-year-old woman

had suffered from glomerulonephritis

which caused death. The autopsy revealed

that the size of her kidneys was 7 х

3 х 2,5 cm, weight 65,0 g, they were

dense and small-grained. Microscopically:

fibrinogenous inflammation of serous

and mucous membranes, dystrophic

changes of parenchymatous organs, brain

edema.What complication can cause such

changes of serous membranes and inner

organs?

A. Uraemia

B. Anemia

C. Sepsis

D. DIC-syndrome

E. Thrombopenia

94. Upper neck node of sympathetic

trunk was removed from the rabbit on

experiment. Reddening and increased

temperature of the skin of head is

observed. What disorder of peripheral circulation

of the blood has developed?

Krok 1 Medicine 2006 11

A. Neuroparalytic arterial hyperemia

B. Neurotonic arterial hyperemia

C. Metabolic arterial hyperemia

D. Venous hyperemia

E. Stasis

95. A tissue sample of benign tumor was

studied under the electron microscope.

A lot of small (15-20 nm) spherical bodies,

consisting of 2 unequal subunits were

detected. These are:

A. Ribosomes

B. Golgi complex

C. Smooth endoplasmic reticulum

D. Microtubules

E. Mitochondria

96. A woman who was infected with

toxoplasmosis during the pregnancy has

born a child with multiple congenital

defects.This is a result of:

A. Teratogenesis

B. Cancerogenesis

C. Biological mutogenesis

D. Chemical mutogenesis

E. Recombination

97. A considerable increase of activity of

МВ-forms of CPK (creatinephosphokinase)

and LDH-1 was revealed on the

examination of patient’s blood. What is

the most likely pathology?

A. Miocardial infarction

B. Hepatitis

C. Rheumatism

D. Pancreatitis

E. Cholecystitis

98. An isolated muscle of a frog

is rhythmically irritated with electric

impulses. Every next impulse is in a period

of relaxation fromthe previus contraction.

What contraction of the muscle occurs?

A. Waved tetanus

B. Single

C. Asynchronous

D. Continuous (smooth) tetanus

E. Tonic

99. A 16-year-old boy was performed an

appendectomy. He has been hospitalized

for right lower quadrant abdominal pain

within 18 hours. The surgical specimen is

edematous and erythematous. Infiltration

by what of the following cells is the most

typical for the process occuring here?

A. Neutrophils

B. Eosinophils

C. Basophils

D. Limphocytes

E. Monocytes

100. ATP synthesis is totaly blocked in a

cell. How will the value of membrane rest

potential change?

A. It will disappear

B. It will be slightly increased

C. It will be considerably increased

D. First it will increase, then decrease

E. First it will decrease, then increase

101. A patient who was previously ill with

mastectomy as a result of breast cancer

was prescribed radiation therapy. What

vitamin preparation has marked radioprotective

action caused by antioxidant

activity?

A. Tocopherol acetate

B. Ergocalciferol

C. Thiamine chloride

D. Riboflavin

E. Folic acid

102. A patient with tissue trauma was

taken a blood sample for the determination

of blood clotting parameters. Specify

the right sequence of extrinsic pathway

activation:

A. III - VIIa - Xa

B. III - IV - Xa

C. IV - VIII: TF - Xa

D. IV - VIIa - Xa

E. III - VIII: TF - Xa

103. Autopsy of a man who died from

chronic cardiacvascular collapse revealed

"tiger heart". Sidewards of endocardium

a yellowish-white banding can be seen;

myocardium is dull, dark-yellow. What

process caused this pathology?

A. Fatty parenchymatous degeneration

B. Carbohydrate degeneration

C. Hyaline degeneration

D. Fatty vascular-stromal degeneration

E. Amyloidosis

104. Parents with an ill child consulted

an infectionist. They had been working in

one of Asian countries for a long time.

The child has sallow skin, loss of appetite,

laxity, enlarged liver, spleen, peripheral

lymph nodes. What protozoal illness can

be suspected?

Krok 1 Medicine 2006 12

A. Visceral leishmaniasis

B. Balantidiasis

C. Amebiasis

D. Toxoplasmosis

E. Lambliasis

105. Healthy parents have got a fairhaired,

blue-eyed girl. Irritability, anxiety,

sleep and feeding disturbance developed

in the first months of the infant’s life.

Neurological examination revealed

developmental lag. What method of

genetic investigation should be used for

the exact diagnosis?

A. Biochemical

B. Cytological

C. Gemellary

D. Genealogical

E. Population-statistical

106. The process of heart transplantation

determined the viability of myocardial

cells. The determination of what

myocardium parameter is the most

important?

A. Rest potential of cardiomyocytes

B. Heart temperature

C. Concentration of oxygen in heart vessels

D. Concentration of calcium-ions in myofibrils

E. Concentration of Ca-ions in heart

vessels

107. The calcium canals of cardiomyocytes

have been blocked on an isolated rabbit’s

heart.What changes in the heart’s activity

can result from it?

A. Decreased rate and force of heart beat

B. Decreased heart beat rate

C. Decreased force of the contraction

D. Heart stops in systole

E. Heart stops in diastole

108. Microscopic examination of the

enlarged neck gland of a 14-year-old

girl revealed destruction of the tissue

structure of the node, absence of

the lymph follicles, sclerotic areas and

necrosis foci, cell constitution of the node

is polymorphous, lymphocites, eosinophiles,

big atypical cells with multilobular

nuclei (Beresovsky-Sternberg cells) and

mononuclear cells of the large size are

present.What is the most likely diagnosis?

A. Lymphogranulomatosis

B. Acute lympholeucosis

C. Chronic lympholeucosis

D. Berkitt’s lymphoma

E. Fungoid mycosis

109. As a result of the damage of one of

the Atomic Power Plant reactors the runout

of radioelements took place. People

in the high-radiation area were radiated

with approximately 250-300 r. They were

immediately hospitalized. What changes

in the blood count would be typical for

the victims?

A. Lymphopenia

B. Leukopenia

C. Anemia

D. Thrombopenia

E. Neutropenia

110. Dystrophic alterations of heart are

accompanied with dilation of heart cavities,

decreased force of heart contractions,

increased blood volume that remains during

systole in the heart cavity, vein overfill.

What heart condition is it typiccal for?

A. Myogenic dilatation

B. Tonogenic dilatation

C. Emergency stage of hyperfunction and

hypertrophy

D. Cardiosclerosis

E. Cardiac tamponade

111. Nowadays about 50 minor bases

have been found in the t-RNA structure

besides the main four nitrogenous bases.

Choose the minor nitrogenous base:

A. Dihydrouracil

B. Uracil

C. Cysteine

D. Adenine

E. Cytosine

112. A 60-year-old patient fell ill with

obturative jaundice as a result of malignant

tumour of the big papillary of the

duodenal. Lumen of what anatomical

structure is compressed by tumour?

A. Hepatopancreatic ampulla

B. Cystic duct

C. Common hepatic duct

D. Right hepatic duct

E. Left hepatic duct

113. Thyrotoxicosis leads to increased

production of thyroidal hormones T 3 and

T 4, weight loss, tachycardia, psychic excitement

and so on. How do thyroidal

hormones effect energy metabolism in the

Krok 1 Medicine 2006 13

mitochondrion of cells?

A. Disconnect oxidation and oxidative

phosphorylation

B. Activate substrate phosphorylation

C. Stop substrate phosphorylation

D. Stop respiratory chain

E. Activate oxidative phosphorylation

114. While shifting the gaze to the closely

situated object the refracting power of

eye’s optical mediums will increase by 10

diopters. It results from changing of such

eye structure:

A. Lens

B. Cornea

C. Vitreous body

D. Liquid of the anterior chamber of eye

E. Muscle that dilatates pupil

115. Necrosis focus appeared in the area

of hyperemia and skin edema in few hours

after burn. What mechanism strengthens

destructive effect in the inflammation

area?

A. Secondary alteration

B. Primary alteration

C. Emigration of lymphocytes

D. Diapedesis of erythrocytes

E. Proliferation of fibroblasts

116. Analeptical remedy of reflective type

from the H-cholinomimetics group was

given to the patient for restoration of

breathing after poisoning with carbon

monoxide. What medicine was prescribed

to the patient?

A. Lobeline hydrochloride

B. Atropine sulphate

C. Adrenalin hydrochloride

D. Mesaton

E. Pentamin

117. A patient operated on complicated

appendicitis has the following changes of

blood count: erythrocytes - 4, 0 · 1012 /l,

Нb - 120 g/l, color index - 0,9, leukocytes

- 18 · 109 /l, basophils - 0, eosinophils

- 0, myelocytes - 0, juvenile - 0,

stab neutrophils - 20, segmentonuclear

neutrophils - 53, lymphocytes - 21,

monocytes - 5. How is such nuclear shift

of leukocytic formula called?

A. Degenerative left shift

B. Right shift

C. Regenerative left shift

D. Hyperregenerative

E. Regeneratively-degenerative

118. A patient has got a spasm of smooth

muscles of bronchi. Activators of what

membrane cytoreceptors are phisiologically

reasoned to stop an attack?

A. β -adrenoreceptors

B. α -аdrenoreceptors

C. α - and β -аdrenoreceptors

D. Н-cholinoreceptors

E. М-cholinoreceptors

119. Intrapleural pressure of an individual

is being measured. In what phase did he

hold his breath if the pressure is - 25 cm

H 2 O?

A. Forced inspiration

B. Quiet expiration

C. Quiet inspiration

D. Forced expiration

E. -

120. Blood sampling for the haematology

is recommended to carry out on an

empty stomach and in the morning. What

changes in blood formula are possible if

blood sampling was carried out after food

intake?

A. Increase of leukocyte number

B. Increase of erythrocyte number

C. Increase of plasm proteins

D. Decrease of thrombocyte number

E. Decrease of erythrocyte number

121. Glomerular filtration rate (GFR)

increased by 20% as a result of prolonged

starvation of an individual. The most evident

cause of filtration changes under this

conditions is:

A. Decrease of oncotic pressure of blood

plasma

B. Increase of systemic blood pressure

C. Increase of penetration of the renal

filter

D. Increase of filtration coefficient

E. Increase of renal plasma stream

122. The ovary specimen colored with

hematoxylin-eosin contains a follicle, in

which cubic-shaped follicle epithelium

cells are placed in 1-2 layers, and scarlet

membrane is seen around the ovocyte.

Name this follicle:

A. Primary

B. Primordial

C. Secondary

D. Mature

E. Atretic

123. A 42-year-old man suffering from

Krok 1 Medicine 2006 14

gout has increased level of urinary acid

in blood. Allopurinol was prescribed

to decrease the level of urinary acid.

Competitive inhibitor of what enzyme is

allopurinol?

A. Xanthine oxidase

B. Adenosine deaminase

C. Adenine phosphoribosiltransferase

D. Hypoxanthine phosphoribosiltransferase

E. Guanine deaminase

124. A child has inhaled a button. Where

is it likely to be?

A. In the right main bronchus

B. In the left main bronchus

C. In the trachea

D. In the larynx

E. In the esophagus

125. A patient with serious damage of

muscular tissue was admitted to the

traumatological department. What biochemical

urine index will be increased

in this case?

A. Creatinine

B. Common lipids

C. Glucose

D. Mineral salts

E. Uric acid

126. Donor skin transplantation was

performed to a patient with extensive

burns. On the 8-th day the graft became

swollen and changed colour; on the 11-th

day graft rejection started.What cells take

part in this process?

A. T-lymphocytes

B. Erythrocytes

C. Basophils

D. Eosinophils

E. B-lymphocytes

127. As a result of craniocerebral trauma

a patient reveals the following symptoms:

intention tremor, dysmetry, adiadochokinesis,

dysarthria. What structure of the

brain is injured?

A. Cerebellum

B. Striatum

C. Motor cortex

D. Pale sphere

E. Black substance

128. A patient with infectious

mononucleosis had been taking

glucocorticoids for two weeks. He was

brought into remission, but he fell ill

with acute attack of chronic tonsillitis.

What action of glucocorticoids caused this

complication?

A. Immunosuppressive

B. Anti-inflammatory

C. Antishock

D. Antiallergic

E. Antitoxic

129. Autopsy of a 12-year-old girl

revealed: multiple cutaneous

hemmorhages (mostly into the skin of

buttocks, lower extremities), serous and

mucous memrane hemmorhages, cerebral

hemmorhages. Adrenal glands show focal

necrosis and massive hemmorhages; kidneys

show necrotic nephrosis, suppurative

arthritis, iridocyclitis, vasculitis. What

is the most probable diagnosis?

A. Meningococcemia

B. Epidemic typhus

C. Periarteritis nodosa

D. Systemic lupus erythematosus

E. Radiation sickness

130. A 68-year-old woman can’t move her

upper and lower right extremities due to

the stroke. Muscle tone of these extremities

and their reflexes are increased. There

are pathological reflexes. What form of

paralysis is it?

A. Hemiplegia

B. Paraplegia

C. Tetraplegia

D. Monoplegia

E. Dissociation

131. Most participants of Magellan

expedition to America died from avitominosis.

This disease declared itself

by general weakness, subcutaneous

hemmorhages, falling of teeth, gingival

hemmorhages. What is the name of this

avitiminosis?

A. Scurvy

B. Pellagra

C. Rachitis

D. Polyneuritis (beriberi)

E. Biermer’s anemia

132. A large-scale reaction with

parapertussis and pertussis diagnosticums

was made in order to make serological

diagnostics of the whooping cough.

At the bottom of the test-tubes with diagnosticum

of Bordetella parapertussis

a granular sediment formed. What antibodies

did this reaction reveal?

Krok 1 Medicine 2006 15

A. Agglutinins

B. Precipitins

C. Opsonins

D. Bacteriolysins

E. Antitoxins

133. Part of the DNA chain turned 180

degree as a result of gamma radiation.

What type of mutation took place in the

DNA chain?

A. Inversion

B. Deletion

C. Doubling

D. Translocation

E. Replication

134. While having the dinner the child

choked and aspirated the food. Meavy

cough has started, skin and mucose are

cyanotic, pulse is rapid, respiration is

infrequent, expiration is prolonged. What

disorder of the external respiration has

the child?

A. Stage of expiratory dyspnea on

asphyxia

B. Stage of inspiratory dyspnea on

asphyxia

C. Stenotic respiration

D. Alternating respiration

E. Biot’s respiration

135. A pregnant woman had been having

toxicosis with severe repeated vomiting

for 24 hours. In the end of the day

there appeared tetanic convulsions and

fluid loss. What shift of acid-base state

caused these changes?

A. Excretory alkalosis

B. Gaseous alkalosis

C. Gaseous acidosis

D. Metabolic acidosis

E. Excretory acidosis

136. After a trauma a 44-year-old patient

had a rupture of left palm muscle tendons

and of the superficial blood vessels. After

operation and removal of the most part

of the necrotically changed muscle tissue

the bloodstream was normalized.

What vessels have helped to restore the

bloodstream?

A. Arcus palmaris profundus

B. Arcus palmaris superficialis

C. Aa. digitales palmares communes

D. Aa. metacarpeae palmares

E. Aa. perforantes

137. An 18-year-old patient has enlarged

inguinal lymphnodes, they are painless,

thickened on palpation. In the area of

genital mucous membrane there is a

small-sized ulcer with thickened edges

and "laquer"bottom of greyish colour.

What is the most probable diagnosis?

A. Syphilis

B. Tuberculosis

C. Lepra

D. Trophic ulcer

E. Gonorrhea

138. A 45-year-old man applied to the

trauma station because of domestic

shoulder trauma. Objectively: extension,

reduction and pronation functions of the

shoulder are absent. What muscle was

injured?

A. Teres major muscle

B. Subscapular muscle

C. Teres minor muscle

D. Infraspinous muscle

E. Supraspinous muscle

139. Diagnostic scraping was performed

to the woman with dysfunctional uterine

bleeding. Multiple convoluted glands,

ganglially dilated lumens of some glands

were revealed histologically in the scrape.

Name the type of general pathological

process in endometry:

A. Hyperplasia glandulocystica

B. Atrophy

C. Metaplasia

D. Displasia

E. Hypertrophic excrescence

140. Tuberculine was introduced

intracutaneously to the child for

tuberculin test. Marked hyperemia, tissue

infiltration developed on the place

of injection in 24 hours. What mechanism

caused these modifications?

A. Cell cytotoxity

B. Reagin type cytotoxity

C. Antibody cytotoxity

D. Granuloma formation

E. Immunocomplex cytotoxity

141. An intraoperational biopsy of

mammal gland has revealed the signs

of atypical tissue presented by disorder

of parenchyma stroma proportion with

domination of the last, gland structures of

different size and shape, lined with singlelayered

proliferative epithelium. What is

the most probable diagnosis?

Krok 1 Medicine 2006 16

A. Fibroadenoma

B. Papilloma

C. Noninfiltrative cancer

D. Infiltrative cancer

E. Mastitis

142. A 34-year-old patient was diagnosed

with chronic glomerulonephritis 3 years

ago. Edemata have developed within the

last 6monthes.What caused the edemata?

A. Proteinuria

B. Hyperproduction of vasopressin

C. Liver dysfunction of protein formation

D. Hyperosmolarity of plasma

E. Hyperaldosteronism

143. An old woman was hospitalized with

acute pain, edema in the right hip joint;

the movements in the joint are limited.

Which bone or part of it was broken?

A. The neck of the thigh

B. The body of the thigh bone

C. Condyle of the thigh

D. Pubic bone

E. Ischial bone

144. Concentration of pyruvate is

increased in the patient’s blood, the most

of which is excreted with urine. What avitaminosis

has the patient?

A. Avitaminosis _1

B. Avitaminosis E

C. Avitaminosis _3

D. Avitaminosis B 6

E. Avitaminosis _2

145. A patient with suspected diphtheria

went through bacterioscopic examination.

Examination of throat swab revealed

rod-shaped bacteria with volutin granules.

What etiotropic preparation should be

chosen in this case?

A. Antidiphtheric antitoxic serum

B. Bacteriophage

C. Diphtheria antitoxin

D. Eubiotic

E. Interferon

146. A patient with diabetes mellitus

experienced loss of consciousness and

convulsions after injection of insulin.

What is the result of biochemical blood

analysis for concentration of the sugar?

A. 1,5 mmol/L

B. 8,0 mmol/L

C. 10,0 mmol/L

D. 3,3 mmol/L

E. 5,5 mmol/L

147. A patient working at a chemical

plant was admitted to the toxicological

department with mercury poisoning.

What medicine should be used?

A. Unithiol

B. Isonitrozin

C. Naloxone

D. Activated carbon

E. Enterosorbent

148. A 63-year-old woman shows

symptoms of rheumatoid arthritis. The

increase of what blood indices could be

the most significant for proving the diagnosis?

A. Additive glycosaminoglycans

B. Lipoproteids

C. Acid phosphatase

D. General cholesterol

E. R-glycosidase

149. An autopsy revealed large (1-2 cm)

brownish-red, easy crumbling formations

covering ulcerative defects on the external

surface of the aortic valve. What is the

most likely diagnosis?

A. Polypous-ulcerative endocarditis

B. Recurrent warty endocarditis

C. Acute verrucous endocarditis

D. Fibroplastic endocarditis

E. Diffusive endocarditis

150. A 7-year-old girl has signs

of anemia. Laboratory examination

revealed pyruvate kinase deficiency

in erythrocytes. What process disturbance

plays the main role in anemia

development?

A. Anaerobic glycolysis

B. Oxidative phosphorylation

C. Tissue respiration

D. Peroxide decomposition

E. Aminoacids desamination

151. A 5-year-old child who often fells ill

with respiratory diseases has eczematous

appearances after consumption of some

food products, tendency to prolonged

course of inflammatory processes. What

kind of diathesis can be suspected in this

case?

A. Exudative-catharral

B. Hemmorhagic

C. Arthritism

D. Lymphohypoplastic

E. Asthenic

152. Low level of albumins and fibriKrok

1 Medicine 2006 17

nogen was detected in the patient’s blood.

Decreased activity of what organelle of

the liver hepatocytes can most probably

cause it?

A. Granular endoplasmatic reticulum

B. Agranular endoplasmatic reticulum

C. Mitochondrions

D. Golgi complex

E. Lysosomes

153. A duodenal content smear of a patient

with indigestion contains protosoa 10-

18 mcm large. They have piriform bodies,

4 pairs of filaments, two symmetrically

located nuclei in the broadened part of

body. What kind of the lowest organisms

is it?

A. Lamblia

B. Dysentery ameba

C. Trichomonas

D. Intestinal ameba

E. Balantidium

154. A 44-year-old woman complains of

common weakness, heart pain, considerable

increase of body weigt. Objectively:

moon-like face, hirsutism, AP-

165/100 mm Hg, height - 164 cm, weight

- 103 kg; fat is mostly accumulated in

the region of neck, upper shoulder girdle,

stomach. What is the main pathogenetic

mechanism of obesity?

A. Increased production of glucocorticoids

B. Decreased production of thyroidal

hormones

C. Increased production of insulin

D. Decreased production of glucagon

E. Increased production of mineralocorticoids

155. After a serious viral infection a 3-

year-old child has repeated vomiting, loss

of consciousness, convulsions. Examination

revealed hyperammoniemia. What

may have caused changes of biochemical

blood indices of this child?

A. Disorder of ammonia neutralization in

ornithinic cycle

B. Activated processes of aminoacids

decarboxylation

C. Disorder of biogenic amines neutralization

D. Increased purtefaction of proteins in

intestines

E. Inhibited activity of transamination

enzymes

156. Albinos can’t stand sun impact - they

don’t aquire sun-tan but get sunburns. Disturbed

metabolism of what aminoacid

underlies this phenomenon?

A. Phenilalanine

B. Methionine

C. Tryptophan

D. Glutamic acid

E. Histidine

157. A 25-year-old patient complained of

the decreased vision. Accommodation disorders,

dilated pupil, lack of reaction for

the light were revealed on examination.

What muscles function is disturbed?

A. Pupil narrowing muscle, ciliary

B. Pupil dilating muscle, ciliary

C. Inferior oblique muscle, ciliary

D. Lateral rectus muscle, pupil narrowing

E. Pupil narrowing and dilating muscles

158. A patient with continious

bronchopneumonia was admitted to

the therapeutic department. Antibiotic

therapy didn’t give much effect. What

medication for improvement of immune

state should be added to t