Beruflich Dokumente
Kultur Dokumente
2009
Krok 1 Medicine 2009 1
28. ECG study showed that the T -waves A. Transport of FFA (free fatty acids) from
were positive in the standard extremity cytosol to the mitochondria
leads, their amplitude and duration were B. Transport of FFA from fat depots to the
normal. The right conclusion would be tissues
that the following process runs normally C. It takes part in one of reactions of FFA
in the heart ventricles: beta-oxidation
D. FFA activation
A. Repolarization E. Activation of intracellular lipolysis
B. Depolarization
C. Excitement 33. In a 2-year-old child with catarrhal
D. Contraction presentations and skin rash a pediatri-
E. Relaxation cian suspected scarlet fever. The child
was given intracutaneously a small dose
29. A patient has an increased pyruvate of serum antibody to the streptococcal
concentration in blood. A large amount erythrogenic toxin; on the site of injection
of it is excreted with the urine. What vi- the rash disappeared. What do the reacti-
tamin is lacking in this patient? on results mean?
A. B1 A. The clinical diagnosis was confirmed
B. E B. The child has hypersensitivity to the
C. B3 erythrogenic toxin
D. B6 C. The disease wasn’t caused by haemolytic
E. B2 streptococcus
D. The whole serum dose may be injected
30. A patient has pellagra. Interrogation intravenously
revealed that he had lived mostly on mai- E. The child has very weak immune system
ze for a long time and eaten little meat.
This disease had been caused by the defi- 34. A patient has a transversal lacerati-
cit of the following substance in the maize: on in the spinal cord. What respiratory
changes will result from this?
A. Tryptophan
B. Tyrosine A. Respiration will present no significant
C. Proline changes
D. Alanine B. Respiration will stop
E. Histidine C. Respiration will become less frequent
D. Respiration will become deeper
31. Study of bacteriological sputum speci- E. Respiration will become more frequent
mens stained by the Ziel-Neelsen method
revealed some bright-red acid-resistant 35. A female patient suffering from
bacilli that were found in groups or si- bronchial asthma had got a viral infecti-
ngularly. When inoculated onto the nutri- on that provoked status asthmaticus wi-
ent media, the signs of their growth show th fatal outcome. Histological examinati-
up on the 10-15 day. These bacteria relate on of lungs revealed spasm and edema of
to the following family: bronchioles, apparent infiltration of their
walls with lymphocytes, eosinophils and
A. Micobacterium tuberculosis other leukocytes; labrocyte degranulati-
B. Yersinia pseudotuberculosis on. What mechanism of hypersensitivity
C. Histoplasma dubrosii underlies the described alterations?
D. Klebsiella rhinoscleromatis
E. Coxiella burnettii A. Reagin reaction
B. Inflammatory
32. A patient with high rate of obesity was C. Autoimmune
advised to use carnitine as a food additive D. Immune complex
in order to enhance "fat burning". What E. Immune cytolysis
is the role of carnitine in the process of fat
oxidation? 36. In the perianal folds of a 5-year-old
girl her mother has found some white
"worms"that caused itch and anxiety in
the child. The "worms"were sent to the
laboratory. During examination the physi-
cian saw white filiform helminths 0,5-1 cm
long, with pointed ends, some helminths
had twisted ends. What is the most likely
Krok 1 Medicine 2009 5
diagnosis? A. Paraproteinemia
B. Hyperalbuminemia
A. Enterobiasis C. Proteinuria
B. Diphyllobothriasis D. Hypoglobulinemia
C. Teniasis E. Hypoproteinemia
D. Ascaridiasis
E. Opisthorchiasis 41. An 8-year-old child was admitted
to the infectious department with fever
37. Examination of a 27-year-old patient (up to 38o C) and punctuate bright-red
revealed pathological changes in liver and skin rash. The child was diagnosed as
brain. Blood plasma analysis revealed an having scarlet fever. Objectively: mucous
abrupt decrease in the copper concentrati- membrane of pharynx is apparently
on, urine analysis revealed an increased hyperaemic and edematic, the tonsils are
copper concentration. The patient was di- enlarged and have dull yellowish-grey foci
agnosed with Wilson’s degeneration. To with some black areas. What inflammati-
confirm the diagnosis it is necessary to on is the reason for the pharynx alterati-
study the activity of the following enzyme ons?
in blood serum:
A. Purulent necrotic
A. Ceruloplasmin B. Fibrinous
B. Carbonic anhydrase C. Haemorrhagic
C. Xanthine oxidase D. Serous
D. Leucine aminopeptidase E. Catarrhal
E. Alcohol dehydrogenase
42. Nappies of a newborn have dark spots
38. A patient complains about dyspnea being the evidence of homogentisic acid
provoked by the physical activity. Clini- formation. This is caused by the metabolic
cal examination revealed anaemia and disorder of the following substance:
presence of the paraprotein in the zone
of gamma-globulins. To confirm the A. Tyrosine
myeloma diagnosis it is necessary to B. Galactose
determine the following index in the pati- C. Methionine
ent’s urine: D. Cholesterol
E. Tryptophan
A. Bence Jones protein
B. Bilirubin 43. A histological specimen presents a
C. Haemoglobin receptor zone of a sensoepithelial sense
D. Ceruloplasmin organ. Cells of this zone are placed upon
E. Antitrypsin the basal membrane and include the
following types: external and internal
39. After a serious psycho-emotional receptor cells, external and internal
stress a 45-year-old patient suddenly felt phalangeal cell, stem cells, external limiti-
constricting heart pain irradiating to the ng cells and external supporting cell. The
left arm, neck and left scapula. His face described receptor zone belongs to the
turned pale, the cold sweat stood out on following sense organ:
it. The pain attack was stopped with ni-
troglycerine. What process has developed A. Acoustic organ
in this patient? B. Visual organ
C. Gustatory organ
A. Stenocardia D. Equilibrium organ
B. Myocardial infarction E. Olfactory organ
C. Stroke
D. Psychogenic shock 44. A patient was admitted to the hospi-
E. Stomach ulcer perforation tal with an asphyxia attack provoked
by a spasm of smooth muscles of the
40. A 62-year-old female patient complai- respiratory tracts. This attack was mai-
ns about frequent pains in the region of nly caused by alterations in the following
thorax and vertebral column, rib fractures. parts of the airways:
A physician suspected myelomatosis
(plasmocytoma). Which of the following
laboratory indices will be of the greatest
diagnostic importance?
Krok 1 Medicine 2009 6
A. Lactate
B. Ketone bodies A. Intensification of leukopoiesis
C. Acetyl CoA B. Redistribution of the leukocytes in the
D. Glucose 6-phosphate organism
E. Oxaloacetate C. Deceleration of leukocyte breakdown
D. Deceleration of leukocyte migration to
108. Cytoplasm of the myocytes contains a the tissues
lot of dissolved metabolites resulting from E. Intensification of leukopoiesis and
glucose oxidation. Name the metabolite deceleration of leukocyte migration to the
that turns directly into lactate: tissues
A. Pyruvate 113. A 35-year-old patient complains
B. Oxaloacetate about having severe rhinitis and loss of
C. Glycerophosphate sense of smell for a week. Objectively: the
D. Glucose-6-phosphate nasal cavity contains a lot of mucus coveri-
E. Fructose-6-phosphate ng the mucous membrane and blocking
olfactory receptors. In what region of the
109. A young man complains about nasal cavity are these receptors located?
urination disorder. Examination of the
external genitals revealed that the urethra A. Superior nasal concha
was split and urine could flow out of this B. Median nasal concha
orifice. What anomaly of the external C. Inferior nasal concha
genitals development is it? D. Common nasal meatus
E. Vestibule of nose
A. Epispadia
B. Phimosis 114. A 10-year-old child had the mantoux
C. Hermaphroditism tuberculin test administered. 48 hours
D. Paraphimosis later a papule up to 8 mm in diameter
E. Hypospadia appeared on the site of the injection.
What type of hypersensitivity reaction
110. A patient consulted an urologist developed after the tuberculin injection?
about pain during urination. Analysis of
his urine taken in the daytime revealed A. Type IV hypersensitivity reaction
eggs with a characteristic sharp point. It is B. Arthus phenomenon
known from the anamnesis that the pati- C. Seroreaction
ent has recently returned from Australia. D. Atopic reaction
What is the most likely diagnosis? E. Type II hypersensitivity reaction
A. Urogenital schistosomiasis 115. Vitamin B1 deficiency causes di-
B. Intestinal schistosomiasis sturbance of oxidative decarboxylati-
C. Japanese schistosomiasis on of α-ketoglutaric acid. This leads to
D. Opisthorchiasis the impaired synthesis of the following
E. Dicroceliasis coenzyme:
111. Colonoscopy of a patient with A. Thiamine pyrophosphate
dysentery revealed that the mucous B. Nicotinamide adenine dinucleotide
membrane of the large intestine was C. Flavine adenine dinucleotide
hyperemic, edematic, and its surface was D. Lipoic acid
covered with grey-and-green layerings. E. Coenzyme A
What morphological form of dysenteric
colitis is it? 116. On the ground of clinical presentati-
ons a patient was prescribed pyri-
A. Fibrinous doxal phosphate. This medication is
B. Catarrhal recommended for correction of the
C. Ulcerous following processes:
D. Purulent
E. Necrotic A. Transamination and decarboxylation of
amino acids
112. Examination of a patient 24 hours B. Oxidative decarboxylation of ketonic
after appendectomy revealed neutrophi- acids
lic leukocytosis with a regenerative shi- C. Desamination of purine nucleotides
ft. What is the most likely mechanism of D. Synthesis of purine and pyrimidin bases
leukocytosis development? E. Protein synthesis
Krok 1 Medicine 2009 14
permanent arm tremor. The patient was 166. A man presents with increased heart
diagnosed with Parkinson’s disease. What rate, mydriatic pupils, dry mouth. This
preparation should be administered? condition results from the activation of
the following system of function regulati-
A. Levodopa on:
B. Phenytoin
C. Phenobarbital A. Sympathetic
D. Diazepam B. Parasympathetic
E. Ethosuximide C. Metasympathetic
D. Vago-insular
162. A patient with coronary artery di- E. Hypothalamo-pituitary-adrenal
sease was admitted to the cardiological
department. For stenocardia prevention 167. A patient with a limb fracture must
a drug from the group of β-adrenoceptor be administered a depolarizing drug from
blockers was administered. What drug is the myorelaxant group for the purpose of
it? a short-time surgery. What drug is it?
A. Metoprolol A. Dithylinum
B. Atropine sulfate B. Tubocurarine chloride
C. Morphine hydrochloride C. Cytitonum
D. Oxytocin D. Atropine sulfate
E. Furosemide E. Pentaminum
163. A 28-year-old female patient 168. A patient suffering from chronic
consulted a gynecologist about sterility. bronchitis takes a synthetic mucolytic
Examination revealed underdeveloped drug that facilitates the sputum thinning.
ovaries and uterus, irregular menstrual What drug is it?
cycle. Analysis of the sex chromatin
revealed 2 Barr’s bodies in most somatic A. Acetylcysteine
cells. What chromosome disease is most B. Diazepam
likely? C. Heparin
D. Furosemide
A. Triple X syndrome E. Enalapril
B. Edwards’ syndrome
C. Patau’s syndrome 169. A patient with massive burns
D. Klinefelter’s syndrome developed acute renal insufficiency
E. Turner’s syndrome characterized by a significant and
rapid deceleration of glomerular fi-
164. A patient with drug intoxication ltration. What is the mechanism of its
presented with the dryness of oral mucous development?
membrane and mydriatic pupils. Such
action of this drug is associated with the A. Reduction of renal blood flow
following effect: B. Damage of glomerular filter
C. Reduction of functioning nephron
A. Muscarinic cholinoreceptor block number
B. Muscarinic cholinoreceptor stumulation D. Rise of pressure of tubular fluid
C. Nicotinic cholinoreceptor stumulation E. Renal artery embolism
D. Adrenoreceptor stimulation
E. Adrenoreceptor block 170. A patient with severe course of respi-
ratory viral infection presented with clini-
165. A newborn develops dyspepsia cal signs of progressing heart failure that
after the milk feeding. When the mi- led to his death in the 2nd week of disease.
lk is substituted by the glucose solution Autopsy revealed that the heart caviti-
the dyspepsia symptoms disappear. The es were significantly dilated, the heart
newborn has the subnormal activity of the was flabby. Histological examination of
following enzyme: the myocardium revealed microvascular
plethora and diffuse stroma infiltration
A. Lactase with lymphocytes and histiocytes. What
B. Invertase is the most likely diagnosis?
C. Maltase
D. Amylase
E. Isomaltase
Krok 1 Medicine 2009 20