Krok Test Base Pathophysiology

1.
In result of the damage of one of the Atomic Power Plant reactor the run-out of radioelements
appened. People in the increased radiation zone were radiated with approximately 250-300 r. They
were immediately hospitalized. What changes in the blood count would be typical?
A. Lymphopenia
B. Leukopenia
C. Anemia
D. Thrombopenia
E. Neutropenia
2. Damage of one of the reactors at a nuclear power plant resulted in runout of radioactive products.
People who were present in the high-radiation area got approximately 250-300 R. They were
urgently taken to the hospital. What blood changes will be typical for this period?
A. Leukopenia
B. Lymphopenia
C. Anemia
D. Thrombocytopenia
E. Neutropenia
3. Having helped to eliminate consequences of a failure at a nuclear power plant, a worker got an
irradiation doze of 500 roentgen. He complains of headache, nausea, dizziness. What
changes in leukocytes quantity can be expected 10 hours after irradiation?
A. Neutrophilic leukocytosis
B. Lymphocytosis
C. Leukopenia
D. Agranulocytosis
E. Leukemia
4. An employee was working with radioactive substances and as a result of an incident he was
irradiated with 4 Gy. He complains about headache, nausea, dizziness. What changes of blood
formula can be expected 10 hours after irradiation?
A. Lymphocytosis
B. Agranulocytosis
C. Neutrophilic leukocytosis
D. Neutropenia
E. Leukopenia
5. After the exposure to ionizing radiation a person was found to have a decrease in blood
granulocyte level. What mechanism underlies these changes?
A. Increased passage of granulocytes into the tissues
B. Leikopoiesis inhibition
C. Autoimmune process development
D. Increased disintegration of leucocytes
E. Disturbed release of mature leukocytes from the bone marrow
6. A disaster fighter at a nuclear power plant developed hemorrhagic syndrome on the background
of acute radiation disease. What is the most important factor of syndrome pathogenesis?
A. Vascular wall damage
B. Increased activity of fibrinolysis factors
C. Thrombocytopenia
D. Increased activity of anticoagulative system factors
E. Decreased activity of coagulative factors
7. A man who took part in disaster-management at a nuclear power plant had hemorrhagic
syndrome at the same time with acute radiation sickness. What is the most important thing for the
pathogenesis of this syndrome?
A. Destructed structure of vessel walls
B. High activity of fibrinolysis factors
C. High activity of anticoagulative blood system
D. Thrombocytopenia
E. Low activity of anticoagulative blood system
8. A patient was delivered to a hospital after having been exposed to ionizing radiation. He presents
with vomiting, anorexia, pain in different region of abdomen, bloody feces, elevation of body
temperature, inertness. Such clinical presentations are typical for the following form of acute
radiation disease:
A. Bone-marrow
B. Cerebral
C. Combined
D. Intestinal
E. Toxemic
9. A 25-year-old man has spent a long time in the sun under high air humidity. As a result of it his
body temperature rose up to 39oC. What pathological process is it?
A. Hyperthermia
B. Infectious fever
C. Hypothermia
D. Noninfectious fever
E. Burn disease
10. Which way of heat emission by the bodies of greenhouse workers is the most effective
at the temperature of 36oC degrees and relative humidity of 70%?
A. Heat radiation
B. Convection
C. –
D. Liquid evaporation
E. Thermal conduction
11. At the end of the working day a worker of a hot work shop has been delivered to a
hospital. The patient complains of a headache, dizziness, nausea, general weakness. Objectively:
the patient is conscious, his skin is hyperemic, dry, hot to the touch. Heart rate is of 130/min.
Respiration is rapid, superficial. What disorder of thermoregulation is most likely to have occurred
in this patient?
A. Increased heat production with no changes to the heat transfer
B. Reduced heat transfer
C. Reduced heat production with no changes to the heat transfer
D. Increased heat transfer and heat production
E. Increased heat transfer and reduced heat production
12. A patient with extensive burns of torso skin exhibits signs of severe intoxication. What stage
of the burn disease is this typical for?
A. Burn toxemia
B. Burn shock
C. Burn infection
D. Burn emaciation
E. Terminal
13. A man got into ice-cold water and died soon as a result of abrupt exposure to cold. In such
cases an organism loses heat most intensively by the way of:
A. Heat conduction and radiation
B. Radiation
C. Heat conduction
D. Convection
E. –
14. Examination of patient with periodontitis revealed the interdependence between the rate of
affection of periodontal tissues and the amount of lysozymes in saliva and gingival liquid. These
results can be obtained during studying the following protection system of an organism:
A. Non-specific resistance
B. Humoral immunity
C. Cellular immunity
D. Auto responsiveness
E. Tolerance
15. Throughout a year a 37-year-old woman periodically got infectious diseases of bacterial
origin, their course was extremely lingering, remissions were short. Examination revealed low
level of major classes of immunoglobulins. The direct cause of this phenomenon may be the
following cell dysfunction:
A. Neutrophils
B. Plasmocytes
C. Phagocytes
D. Macrophages
E. Lymphocytes
16. A patient with skin mycosis has disorder of cellular immunity. The most typical characteristic
of it is reduction of the following index:
A. T-lymphocytes
B. Immunoglobulin G
C. Immunoglobulin E
D. B-lymphocytes
E. Plasmocytes
17. After an immunoassay a child was diagnosed with immunodeficiency of humoral immunity.
What is the reason for the primary immunodeficiency development in the child?
A. Toxic damage of B-lymphocytes
B. Hereditary abnormality of immune system
C. Pathometabolism in mother's organism
D. Embryonal development abnormalities
E. Immune responsiveness and resistance disorders
18. A child was born with cleft palate. Examination revealed aorta defects and reduced number of
T-lymphocytes in blood. What immunodeficient syndrome is it?
A. DiGeorge
B. Wiskott-Aldrich
C. Chediak-Higashi
D. Louis-Bar
E. Swiss-type
19. Examination of a child who frequently suffers from infectious diseases revealed that IgG
concentration in blood serum was 10 times less than normal, IgA and IgM concentration was also
significantly reduced. Analysis showed also lack of B-lymphocytes and plasmocytes. What disease
are these symptoms typical for?
A. Swiss-type agammaglobulinemia
B. Di George syndrome
C. Bruton’s disease
D. Dysimmunoglobulinemia
E. Louis-Bar syndrome
20. Examination of a pregnant woman having Rh-negative blood revealed high level of
antierythrocytic antibodies. For its reduction she was implanted with her husband's Rh-positive
skin graft. The graft was rejected in two weeks. Its microscopic examination revealed circulatory
disturbance, edema and cellular infiltration with lymphocytes, neutrophils and macrophages
predominance. What is the most likely pathology?
A. Interstitial inflammation
B. Delayed-type hypersensitivity
C. Graft immunity
D. Immediate hypersensitivity
E. Granulomatous inflammation
21. A 12-year-old boy often suffers from virus and bacterial infections and eczematous skin
lesions. Enlargement of T-lymphocytes and IgM with normal IgA and IgG was revealed on
examination. What type of immune system pathology is presented in the patient?
A. Composite immunodeficiency
B. Hypoplasia of thymus
C. Bruton's hypogammaglobulinemia
D. Turner's syndrome
E. Hereditary immunodeficiency of the complement system
22. Parents of a 5-year-old report him to have frequent colds that develop into pneumonias,
presence of purulent rashes on the skin. Laboratory tests have revealed the following: absence of
immunoglobulins of any type, and naked cells are absent from the lymph nodes punctate. What
kind of immune disorder is it ?
A. Louis-Barr syndrome
B. X-linked hypogammaglobulinemia (Bruton type agammaglobulinemia)
C. Hypoplastic anemia
D. Autosomal recessive agammaglobulinemia (Swiss type)
E. Agranulocytosis
23. The development of both immune and allergic reactions is based upon the same mechanisms
of the immune system response to an antigen. What is the main difference between the immune
and allergic reactions?
A. Amount of released antigen
B. Development of tissue lesion
C. Antigen structure
D. Routes by which antigens are delivered into the body
E. Hereditary predisposition
24. A surgeon used novocaine as an anaesthetic during surgical manipulations. 10 minutes after it
the patient became pale, he got dyspnea and hypotension. What type of allergic reaction is it?
A. Anaphylactic
B. Cytotoxic
C. Immune complex
D. Stimulating
E. Cell-mediated
25. During surgical manipulations a patient has been given novocaine injection for anesthesia. 10
minutes later the patient developed paleness, dyspnea, hypotension. What type of allergic reaction
is it?
A. Cellulotoxic immune reaction
B. Cell-mediated immune reaction
C. Stimulating immune reaction
D. Anaphylactic immune reaction
E. Aggregate immune reaction
26. What condition may develop 15-30 minutes after re-administration of the antigen is a result of
the increased level of antibodies, mainly IgE, that are adsorbed on the surface of target cells,
namely tissue basophils (mast cells) and blood basophils?
A. Delayed-type hypersensitivity
B. Anaphylaxis
C. Immune complex hyperresponsiveness
D. Serum sickness
E. Antibody-dependent cytotoxicity
27. A 22-year-old woman ate some seafood. 5 hours later the trunk and the distal parts of limbs
got covered with small itchy papules which were partially fused together. After one day, the rash
disappeared spontaneously. Specify the hypersensitivity mechanism underlying these changes:
A. Antibody-dependent cell-mediated cytolysis
B. Immune complex hypersensitivity
C. Cellular cytotoxicity
D. Systemic anaphylaxis
E. Atopy (local anaphylaxis)
28. A 27- year-old woman has dropped penicillin containing eye drops. In few minutes there
appeared feeling of itching, burning of the skin, lips and eyelids edema, whistling cough,
decreasing of BP. What antibodies take part in the development of this allergic reaction?
A. IgE and IgG
B. IgM and IgG
C. IgA and IgM
D. IgM and IgD
E. IgG and IgD
29. A 27 y.o. patient put eye drops that contain penicillin. After a few minutes she felt itching and
burning of her body, there appeared lip and eye-lid edemata; arterial pressure began to drop. What
immunoglobulins took part in the development of this allergic reaction?
A. IgE and IgG
B. IgM and IgG
C. IgA and IgM
D. IgM and IgD
E. IgG and IgD
30. A teenager had his tooth extracted under novocaine anaesthesia. 10 minutes later he presented
with skin pallor, dyspnea, hypotension. When this reaction is developed and the allergen achieves
tissue basophils, it reacts with:
A. IgА
B. IgD
C. ІgМ
D. T-lymphocytes
E. IgE
31. Skin samples of a patient with bronchial asthma revealed allergen sensitization of poplar fuzz.
What factor of immune system plays the main part in development of this immunopathological
state?
A. IgD
B. IgM
C. IgE
D. Sensitized Т-lymphocytes
E. –
32. During allergic rhinitis (inflammation of the nasal mucosa) the number of basophils in the
connective tissue of the mucosa increases, which is accompanied by a tissue edema. This
phenomenon is associated with the following function of tissue basophils:
A. Histamine synthesis
B. Heat production
C. Production of intercellular substance
D. Antibody formation
E. Phagocytosis
33. A patient was stung by a bee. Examination revealed that his left hand was hot, pink, edematic,
there was a big red blister on the site of sting. What is the leading mechanism of edema
development?
A. Increased vessel permeability
B. Reduced vessel filling
C. Injury of vessels caused by the sting
D. Drop of oncotic pressure in tissue
E. Drop of osmotic pressure in tissue
34. A patient was stung by a bee. Examination results: his left hand is hot, pink and edematic, there
is a big blister on the spot of the sting. What is the leading mechanism of edema development?
A. Reduced blood filling of vessels
B. Vascular damage caused by the sting
C. Reduction of oncotic pressure of tissue
D. Increased vascular permeability
E. Reduction of osmotic pressure of tissue
35. A patient was diagnosed with autoimmune hemolytic cytotoxic anemia. What substances are
antigens in II type allergic reactions?
A. Modified receptors of cell membranes
B. Antibiotics
C. Hormones
D. Serum proteins
E. Inflammation modulators
36. A patient has been diagnosed with acute glomerulonephritis that developed after he had had
streptococcal infection. It is most likely that the affection of basal glomerular membrane is caused
by an allergic reaction of the following type:
A. Anaphylactic
B. Cytotoxic
C. Delayed
D. Stimulating
E. Immune complex
37. 10 days after having quinsy caused by beta-hemolytic streptococcus a 6-year-old child
exhibited symptoms of glomerulonephritis. What mechanism of glomerular lesion is most likely
in this case?
A. Atopy
B. Antibody-dependent cell-mediated cytolysise
C. Anaphylaxis
D. Cellular cytotoxicity
E. Immunocomplex
38. A male patient has been diagnosed acute post-streptococcal glomerulonephritis. It is most
likely that the lesion of the basement membrane of renal corpuscles was lused by the following
allergic reaction:
A. Delayed
B. Cytotoxic
C. Immune complex
D. Stimulating
E. Anaphylactic
39. A woman has been applying a new cosmetic preparation for a week that resulted in eye-lid
inflammation accompanied by hyperemia, infiltration and painfulness. What type of allergic
reaction was developed?
A. ІV
B. I
C. II
D. III
E. V
40. A 10-year-old child had the mantoux tuberculin test administered. 48 hours later a papule up
to 8 mm in diameter appeared on the site of the injection. What type of hypersensitivity reaction
developed after the tuberculin injection?
A. Type II hypersensitivity reaction
B. Atopic reaction
C. Arthus phenomenon
D. Type IV hypersensitivity reaction
E. Seroreaction
41. A child with suspected tuberculosis was given Mantou test. After 24 hours the site of the
allergen injection got swollen, hyperemic and painful. What are the main components that
determine such response of the body?
A. Plasma cells, T-lymphocytes and lymphokines
B. B-lymphocytes, IgM
C. Macrophages, B-lymphocytes and monocytes
D. Granulocytes, T-lymphocytes and IgG
E. Mononuclear cells, T-lymphocytes' and lymphokines
42. Tuberculine was injected intraperitoneally to the animal sensibilized with tuberculine. Venous
hyperemia and peritonial edema were detected on the laparotomy in 24 hours. Increased amount
of lymphocytes and monocytes were in the smear-print from the peritonium. What pathological
process is in the animal?
A. Allergic inflammation
B. Serous inflammation
C. Suppurative inflammation
D. Fibrinous inflammation
E. Aseptic inflammation
43. A 10-year-old child cut his leg with a piece of glass and was sent to a clinic for an anti-tetanus
serum injection. In order to prevent the development of anaphylactic shock the Besredka
desensitisation method was applied. What mechanism underlies this method?
A. Inhibited synthesis of mast cells mediators
B. Stimulation of the immunological antigen tolerance
C. Binding to IgE fixed to mast cells
D. Stimulation of antigen-specific IgG2 synthesis
E. Binding of IgE receptors on mast cells
44. A child cut his leg with a piece of lass while playing and was brought to the clinic for the
injection of tetanus toxoid, an order to prevent the development of anaphylactic shock the serum
was administered by Bezredka method. What mechanism underlies this method of desensitization
of the body?
A. Binding of IgE fixed to the mast cells
B. Stimulation of the synthesis of antigen-specific IgG
C. Blocking the mediator synthesis in the mast cells
D. Stimulation of immune tolerance to the antigen
E. Binding of IgE receptors to the mast cells
45.During blood transfusion a patient has developed intravascular erythrocyte hemolysis. What
kind of hypersensitivity does the patient have ?
A. I type (anaphylactic)
B. IV type (granulomatosis)
C. IV type (cellular cytotoxicity)
D. II type (antibody-dependent)
E. III type (immune complex)
46. Several minutes after a dentist administered novocaine for local anesthesia of a patient’s tooth,
the following symptoms sharply developed in the patient: fatigue, skin itching. Objectively the
following can be observed: skin hyperemia, tachycardia, BP dropped down to 70/40 mm Hg. What
kind of allergic reaction is this pathology ?
A. Immune complex
B. Cytotoxic
C. Stimulating
D. Cell-mediated immune reaction
E. Anaphylactic
47. A 12-year-old child has developed nephritic syndrome (proteinuria, hematuria, cylindruria) 2
week after the case of tonsillitis, which is a sign of affected glomerular basement membrane in the
kidneys. What mechanism is the most likely to cause the basement membrane damage ?
A. Granulomatous
B. Cytotoxic
C. Immune complex
D. Reaginic
E. Antibody-mediated
48. A 12-year-old boy came home from school and started complaining of headache,
sickness, chill, periodical muscle pain, appetite loss, flabbiness. What period of illness are these
are these symptoms typical for?
A. Prodromal
B. Latent
C. Incubative
D. High point of illness
E. End of illness
A patient has been administered conduction anesthesia with novocaine in preparation for tooth
extraction. After the anesthesia administration the patient developed swelling and hyperemy
around the injection site, skin itch, general fatigue, motor agitation. Name the developed
complication:
A. Tachyphylaxis
B. Idiosyncrasy
C. Allergy
D. Drug dependence
E. Inflammation
A woman resting in the countryside has been stung by a bee. Immediately after she developed pain
in the stung area. In a few minutes there developed a vesicle, erythema and intense itch; later -
urticaria and expiratory dyspnea. What factors resulted in the patient developing expiratory
dyspnea?
A. Adrenaline
B. Histamine
C. Noradrenaline
D. Hageman's factor
E. Lysosomal enzymes
49. There is a severe time restriction for people's staying at a height of over 800 m above the sea
level without oxygen bombs. What is the life limiting factor in this case?
A. Partial oxygen pressure
B. Moisture level
C. Temperature
D. Earth gravity
E. Ultraviolet intensity
50. There is a strict time limit for people to stay at a height of 8000 m above sea level without
oxygen cylinders. Specify the life-limiting factor in this case:
A. Humidity rate
B. Partial pressure of oxygen in air
C. Rate of ultraviolet radiation
D. Earth gravity
E. Temperature
51. Climbing the mountains at a height of 5000 m climbers started complaining of breath shortness,
palpitation, vertigo, ring in the ears. What pathogenetic factor determines the development of these
occurrences?
A. Hypoxemia
B. Hypokalemia
C. Decreased oxygen capacity of blood
D. Lactacidemia
E. Hypernatremia
52. A group of students who were climbing up a mountain presented with euphoria, tachypnea,
tachycardia. Specify the immediate reason for hypocapnia accompanying mountain sickness:
A. Erythrocytosis
B. Increase in respiration rate and depth
C. Increase in heart rate
D. Decrease in respiration depth
E. Anaemia
53. A man permanently lives high in the mountains. What changes of blood characteristics can be
found in his organism?
A. Increase of erythrocytes number
B. Decrease of colour index of blood
C. Decrease of reticulocytes number
D. Erythroblasts in blood
E. Decrease of hemoglobin content
54. A group of mountain climbers went through the blood analysis at the height of 3000 m. It
revealed decrease of HCO3 to 15 micromole/l (standard is 22-26 micromole/l). What is the
mechanism of HCO3 decrease?
A. Intensification of acidogenesis
B. Hypoventilation
C. Hyperventilation
D. Decrease of ammoniogenesis
E. Decrease of bicarbonate reabsorption in kidneys
55. After a diver had dived to a depth of 60 meters he got the following symptoms of CNS
dysfunction: anxiety, euphoria, lack of attention, professional errors. These symptoms are
associated with neurons being under a toxic effect of:
A. Oxygen
B. Carbon dioxide
C. Ammonia
D. Nitrogen
E. Lactate
56. A diver who has been staying at the depth of 40 m for a long time fell ill with caisson disease
as a result of decompression. The main pathogenetic factor is the following embolism:
A. Gaseous
B. Air
C. Fat
D. Paradoxical
E. Tissue
57. In course of parallel experiments some rats were being subjected to continuous direct solar
irradiation and some were being irradiated while placed into a glass box. The animals that received
a doze of direct irradiation got tumours on parts of their skin not coated with hair. This
phenomenon is associated with the influence of the following factor:
A. Exogenous chemical carcinogens
B. Biological carcinogens
C. Ultraviolet radiation
D. Infrared radiation
E. Endogenous chemical carcinogens
58. A child is pale, pastose, muscular tissue is bad developed, lymph nodes are enlarged. He often
suffers from angina and pharyngitis, blood has signs of lymphocytosis. The child is also
predisposed to autoallergic diseases. What type of diathesis can be presumed in this case?
A. Exudative
B. Gouty
C. Asthenic
D. Lymphohypoplastic
E. Hemorrhagic
59. A 30-year-old man died from electrocution. What was the cause of death?
A. Acute respiratory failure
B. Internal hemorrhage
C. Shock
D. Acute renal failure
E. Central respiratory arrest
60. A person is in a room with air temperature of 38°C and relative air humidity of 50%. What
type of heat transfer ensures mai ntenance of constant body core temperature under these
conditions?
A. Convection
B. Conduction and convection Radiation
С. Evaporation
D. –
E. Evaporation
61. A 13-year-old boy presents with eczematous rashes on his shins and torso. Anamnesis states
cases of otitis, pneumonia, and furuncles in the patient. Blood test: platelets – 70*109/1, low
activity of T helper and T suppressor cells, low IgM, with normal IgA and IgG. What
immunodeficient disease does this boy have?
A. Louis-Bar syndrome Ataxia- telangiectasia)
B. Severe combined immunodeficiency (Swiss type)
C. DiGeorge syndrome
D. Wiskott-Aldrich syndrome
E. Chediak-Higashi syndrome
62. During ascent into mountains a person develops increased respiration rate and rapid heart rate.
What is the cause of these changes?
A. Increase of nitrogen content in air
B. Increase of С02 partial pressure
C. Increase of blood pH
D. Increase of air humidity
E. Decrease of O2 partial pressure
63. A 5-year-old child is diagnosed with Bruton syndrome (X-linked agamma-globulinemia) that
manifests itself in severe clinical course of bacterial infections and absence of B lymphocytes and
plasma cells. What changes of immunoglobulin content can be observed in blood serum of the
child with immunodeficiency
A. Decreased IgD, IgE
B. No changes
C. Increased IgA, IgM
D. Increased IgD, IgE
E. Decreased IgA, IgM
64. A 5-year-old child is diagnosed with Bruton syndrome (X-linked agammaglobulinemia) that
manifests itself as severe clinical course of bacterial infections and absence of B lymphocytes and
plasma cells. What changes of immunoglobulin content can be observed in blood serum of the
child with immunodeficiency?
A. Decreased IgA, IgM
B. Increased IgD, IgE
C. Increased IgA, IgM
D. Decreased IgD, IgE
E. No changes
65. A patient with clinical signs of a primary immunodeficiency has functionally disturbed
mechanism of antigen-presentation to the immunocompetent cells. What cells are likely to have
structural defects?
A. Macrophages, monocytes
B. B-lymphocyte
C. T-lymphocyte
D. O-lymphocytes
E. Fibroblasts
66. Due to prolonged stay in the mountains at the altitude of 3000 m above the sea level, a person
developed increased oxygen capacity of blood, which was directly caused by intensified
production of:
A. Erythropoietins
B. Leukopoietins
C. Catecholamines
D. Carbaminohemoglobin
E. 2,3-bisphosphoglycerate
67. Antileukocytic antibodies are detected in the blood of a patient with leukopenia. What type of
Coombs-Gell hypersensitivity reaction developed in this case?
A. Stimulating
B. Immune complex-mediated
C. Anaphylactic
D. Delayed-type hypersensitivity
E. Cytotoxic
68. A 35-year-old man had been suffering from bronchial asthma for along time. Eventually he
developed a status asthmaticus that became lethal. Examination of section materials shows a
bronchiolar spasm in the lungs. The bronchiolar walls shows signs of cellular infiltration with
predominance of eosinophilic leukocytes and lymphocytes, labrocytes with signs of degranulating
are observed. What mechanism of hypersensitivity is the cause of these changes?
A. Cell-mediated cytotoxicity
B. -
C. Immune complex
D. Antibody-dependent
E. Reaginic reaction
69. A 50-year-old man has been undergoing treatment for peptic ulcer disease of the stomach. His
digestion normalized, pain disappeared, and general mood improved. However, several weeks
later he again developed epigastric pain, heartburn, and sour eructation. How can this clinical
course be characterized?
A. Terminal state
B. Prodromal stage
C. Latent period
D. Relapse
E. Remission
70. 30 minutes after the dental treatment the patient developed red itching spots on the face and
oral mucosa. The patient was diagnosed with urticaria. What bioactive substance with vasodilating
and pruriginous effect is produced during this type of allergic reaction?
A. Histamine
B. Interleukin-1
C. Bradykinin
D. Leukotriene B4
E. Prostaglandin E2
71. A 36-year-old man traveled to the mountains for a vacation (altitude of 2000 meters above the
sea level). He developed increased respiration rate, tachycardia, and slight dizziness. Two days
later these signs disappeared. This process is called:
A. Compensation
B. Proliferation
C. Inhibition
D. Regeneration
E. Adaptation
1. While playing volleyball a sportsman made a jump and landed on the outside edge of his
foot. He felt acute pain in the talocrural joint, active movements are limited, passive movements
are unlimited but painful. A bit later there appeared a swelling in the area of external ankle, the
skin became red and warm. What type of peripheral circulation disturbance is the case?
+Arterial hyperemia
-Stasis
-Embolism
-Venous hyperemia
-Thrombosis
2. A 42 year old woman with neuralgia of trifacial nerve complains about periodical
reddening of the right part of her face and neck, sense of warmth gush, increased skin sensitivity.
These effects can be explained by the following type of arterial hyperemia:
+Neurotonic
-Neuroparalytic
-Metabolic
-Functional
-Reactive
3. A student failed to answer all the questions of examination paper correctly. As a result he
blushed, felt hot and lost confidence. What type of arterial hyperemia has developed in this case?
+Neurotonic hyperemia
-Postishemic hyperemia
-Pathologic hyperemia
-Metabolic hyperemia
-Neuroparalytic hyperemia
4. 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 form of peripheral
circulation of the blood developed in the rabbit?
+Neuroparalytic arterial hyperemia
-Neurotonic arterial hyperemia
-Metabolic arterial hyperemia
-Venous hyperemia
-Stasis
5. A rabbit’s nerve that innervates the right ear was cut and its right superior cervical ganglion
was removed. Immediately after operation the temperature of ear skin was measured. It was
revealed that the temperature of the rabbit's ear skin on the side of denervation was by 1,50C
higher than on the opposite intact side. What of the following is the most probable explanation of
the above-mentioned effects?
+Arterial neuroparalytic hyperemia
-Arterial neurotopical hyperemia
-Arterial hyperemia induced by metabolic factors
-Reactive arterial hyperemia
-Physiological arterial hyperemia
6. A patient with obliterating endarteritis underwent ganglionic sympathectomy. What type

of arterial hyperaemia should have developed as a result of the surgery?
+Neuroparalytic
-Neurotonic
-Metabolic
-Functional
-Reactive
7. A patient with obliterating atherosclerosis underwent sympathectomy of femoral artery in

the region of femoral trigone. What type of arterial hyperemia was induced by the operation?
+Neuroparalytic
-Reactive
-Metabolic
-Neurotonic
-Functional
8. A patient with periodontitis has developed gingival edema. The gums are of dark red
colour. What local circulation disorder prevails in the gums of the patient?
+Venous hyperemia
-Arterial hyperemia
-Ischemia
-Thrombosis
-Embolism
A 25-year-old patient complains of increasing pain in his leg muscles occurring during walking
and forcing him to make frequent stops. Objectively: skin of legs is pale, no hair-covering, toenails
are with trophic changes, no pulsation of pedal arteries. The most probable cause of these changes
is:
A. Venous hyperemia
B. Arterial hyperemia
C. –
D. *Ischemia
E. Embolism
9. A 70-year-old patient suffers from atherosclerosis complicated by the lower limb

thrombosis that has caused gangrene on his left toes. What is the most likely cause of the
thrombosis origin?
+Thrombocyte adhesion
-Prothrombinase activation
-Transformation of prothrombin into thrombin
-Transformation of fibrinogen into fibrin
-Impaired heparin synthesis
10. A 65 year old patient suddenly died. She suffered from thrombophlebitis of deep veins of
shin. Autopsy revealed: trunk and bifurcation of pulmonary artery contain red loose masses with
dull corrugated surface. What pathological process did the morbid anatomist reveal in pulmonary
artery?
+Thromboembolism
-Thrombosis
-Tissue embolism
-Foreign body embolism
-Fat embolism
11. A 54-year-old female was brought to the casualty department after a car accident. A
traumatologist diagnosed her with multiple fractures of the lower extremities. What kind of
embolism is most likely to develop in this case?
+Fat
-Tissue
-Gaseous
-Thromboembolism
-Air
A man has suffered multiple bone fractures of his lower extremities during a traffic accident.
During transportati-on to a hospital his condition was further aggravated: blood pressure
decreased, there were signs of pulmonary artery embolism. What kind of embolism is the most
likely in the given case?
A. Gas embolism
B. Tissue embolism
C. Fat embolism
D. Air embolism
E. Thromboembolism
12. Necrosis focus appeared in the area of hyperemia and skin edema in few hours after burn.
What mechanism strengthens destructive events in the inflammation area?
+Secondary alteration
-Primary alteration
-Emigration of lymphocytes
-Diapedesis of erythrocytes
-Proliferation of fibroblasts
13. Inflammation of a patient's eye was accompanied by accumulation of turbid liquid with
high protein at the bottom of anterior chamber that was called hypopyon. What process underlies
the changes under observation?
+Disturbance of microcirculation
-Primary alteration
-Secondary alteration
-Proliferation
-–
14. The cellular composition of exudate largely depends on the etiological factor of
inflammation. What leukocytes are the first to get into the focus of inflammation caused by
pyogenic bacteria?
+Neutrophil granulocytes
-Basophils
-Myelocytes
-Monocytes
-Eosinophilic granulocytes
15. Inflammation is characterised by increasing penetration of vessels of microcirculation

stream, increasing of their fluid dynamic blood pressure. Increasing of the osmotic concentration
and dispersity of protein structures present in the intercellular fluid. What kind of edema will
appear in this case?
+Mixed
-Hydrodynamic
-Colloid-osmotic
-Lymphogenic
-Membranogenic
16. Inflammatory processes cause synthesis of protein of acute phase in an organism. What
substances stumulate their synthesis?
+Interleukin-1
-Immunoglobulins
-Interferons
-Biogenic amins
-Angiotensin
17. On simulation of inflammation of the lower extremity the animal exrerienced raise of the
temperature, increase of amount of antibodies and leucocytes in the blood. What substances caused
this general reaction of the organism on inflammation?
+Interleukin
-Glucocorticoid
-Mineralcorticoid
-Leucotriens
-Somatomedins
18. A patient with inflammation of trigeminal nerve has been having progressive paradontitis
for some years. What factor is the most important for parodontitis development?
+Neurodistrophic disorders
-Low activity of leukocytic elastase
-Poor formation of immunoglobulins
-Increased tone of vagus nerve
-Low activity of kallikrein-kinin system
A 7-year-old child has acute onset of disease: temperature rise up to 38 °C, rhinitis, cough,
lacrimation and large-spot rash on the skin. Pharyngeal mucosa is edematous, hyperemic, with
whitish spots in the buccal area. What kind of inflammation causes the changes in the buccal
mucosa ?
A. Serous inflammation
B. Catarrhal inflammation
C. Suppurative inflammation
D. Hemorrhagic inflammation
E. Fibrinous inflammation
19. A patient who suffers from pneumonia has high body temperature. What biologically active
substance plays the leading part in origin of this phenomenon?
+Interleukin-1
-Histamine
-Bradykinin
-Serotonin
-Leukotrienes
20. After transfusion of 200 ml of blood a patient presented with body temperature rise up to
o
37,9 C. Which of the following substances is the most likely cause of temperature rise?
+Interleukin-1
-Interleukin-2
-Tumour necrosis factor
-Interleukin-3
-Interleukin-4
21. A patient dropped into an ice hole, froze in the wind and fell ill. Body temperature rose up
to 39,7 C and varied from 39oC to 39,8oC. Name the type of the patient's temperature profile?
o
+Febris continua
-Febris recurrens
-Febris hectica
-Febris intermittens
-Febris remittens
22. The body temperature of a patient with an infectious disease rises once in two days up to
39,5-40,5oС and stays so for about an hour and then drops to the initial level. What type of fever
is it?
+Intermittent
-Continued
-Remittent
-Hectic
-Atypical
23. In a patient elevation of body temperature takes turns with drops down to normal levels
during the day. The rise in temperature is observed periodically once in four days. Specify the type
of temperature curve:
+Febris intermittens
-Febris continua
-Febris reccurens
-Febris hectica
-Febris remitens
24. A patient with lobar pneumonia has had body temperature of 39oC with daily temperature
fluctuation of no more than 1oC for 9 days. This fever can be characterized by the following
temperature curve:
+Persistent
-Hectic
-Remittent
-Hyperpyretic
-Recurrent
This year influenza epidemic is characterised by patients' body temperature varying from 36,9°C
to 37,9°C. Such fever is called:
A. Apyretic
B. Hyperpyretic
C. High
D. Moderate
E. Subfebrile
25. A patient consulted a dentist about itching and burning in the oral cavity; high temperature.
The patient was diagnosed with trichomonal gingivostomatitis. What drug should be chosen for
his treatment?
+Metronidazole
-Ampicillin
-Doxycycline hydrochloride
-Gentamicin sulfate
-Nystatin
26. A 62 year old patient who previously worked as stoker was admitted to a hospital with
complaints about general weakness, abrupt weight loss, hoarse voice, dyspnea, dry cough.
Laryngoscopy revealed a tumour in the pharynx that invaded vocal cords and epiglottis. What is
the most probable cause of tumour development?
+Polycyclic aromatic carbohydrates
-Nitrosamines
-Aromatic amines and amides
-Retroviruses
-Ionizing radiation
27. A 45-year-old woman has breast cancer. Her left arm has symptoms of lymphatic system
insufficiency – limb edema, lymph node enlargement. What form of lymphatic circulation
insufficiency is it?
+Mechanic insufficiency
-Combined insufficiency
-Dynamic insufficiency
-Resorption insufficiency
-–
28. A female patient has been diagnosed with cervical erosion, which is a precancerous
pathology. What defense mechanism can prevent the development of a tumor?
+Increase in natural killer level (NK-cells)
-High-dose immunological tolerance
-Increase in the activity of lysosomal enzymes
-Simplification of the antigenic structure of tissues
-Low-dose immunological tolerance
29. Measurements of the arterial pC02 and pO2 during an attack of bronchial asthma revealed
hypercapnia and hypoxemia respectively. What kind of hypoxia occurred in this case?
+Respiratory
-Hemic
-Circulatory
-Tissue
-Histotoxic
30. A 56 y.o. patient has been suffering from thyreotoxicosis for a long time. What type of
hypoxia can be developed?
+Tissue
-Hemic
-Circulatory
-Respiratory
-Mixed
When ascending to the top of Elbrus, a mountain climber experiences oxygen 4 starvation,
dyspnea, palpitations, and i numbness of the extremities. What kind of hypoxia has developed in
the mountain climber?
A. Hypoxic
B. Circulatory
C. Tissue
D. Cardiac
E. Hemic
A patient with chronic heart failure resents with increased blood viscosity. Capilaroscopy detected
damage to the vessel walls of the microcirculation system. What disorder is possible in the given
case?
A. Embolism,
B. Blood "sludge" phenomenon
C. Arterial hyperemia
D. Venous hyperemia
E. Thrombosis
A patlent with pneumonla has body temperature of 39,2 C. What cells are the
main producers of endogenous pyrogen that had caused such tempefature rise?
A. Monocytes
B. Eosinophils
C. Endotheliocytes
D. Neutrophils
E. Fibroblasts
A 63-year-old man suffers from esophageal carcinoma presents with metastases into the
mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process
is observed in the patient?
A. Transformation
B. -
C. Progression
D. Initiation
E. Promotion
A 45-year-old man diagnosed with hepatic cirrhosis and ascites underwent drainage of 5 liters of
fluid from his abdominal cavity, which resulted in development of syncopal state due to
insufficient blood supply to the brain. What circulatory disorder occurred in the abdominal cavity
in this case?
A. Venous hyperemia
B. Embolism
C. Arterial hyperemia
D. Thrombosis
E. Ischemia
A 30-year-old man complains of suffocation, heaviness in the chest on the right, general weakness.
Body temperature is 38.9oC. Objectively the right side of the chest lags behind the left side during
respiration. Pleurocentesis yielded exudate. What is the leading factor of exudation in the patient?
A. Increased permeability of the vessel wall
B. Hypoproteinemia
C. Increased blood pressure
D. Decreased resorption of pleural fluid
E. Erythrocyte aggregation
A 63-year-old man suffers from esophageal carcinoma, presents with metastases into the
mediastinal lymph nodes and cancerous cachexia. What pathogenetic stage of neoplastic process
is observed in the patient?
A. Progression
B. -
C. Transformation
D. Initiation
E. Promotion
A 30-year-old person has been stung by a bee. The stung area exhibits edema, hyperemia, and
elevated temperature. What is the initial pathogenetic factor of inflammatory edema in this case?
A. Increase of capillary blood pressure
B. Increase of microvascular permeability
C. Decrease of oncotic blood pressure
D. Increase of osmotic pressure in the inflammation focus
E. Disturbed lymphatic efflux
After a mechanical injury a tourniquet was applied to the patient's arm to stop the bleeding. Below
the tourniquet the arm became pale and numb. This condition is caused by:
A. Obstruction ischemia
B. Angiospastic ischemia
C. Thrombosis
D. Compression ischemia
E. Venous congestion
Lower limbs of a patient with varicose veins were examined. The patient's legs are cyanotic and
pastose, skin temperature is low, single petechiae are observed. What disturbance of
hemodynamics is it?
A. Obstruction ischemia
B. Compression ischemia
C. Thromboembolism
D. Arterial hyperemia
E. Venous hyperemia
1. After recovering from epidemic parotiditis a patient began to lose weight, he was permanently
thirsty, drank a lot of water, had frequent urination, voracious appetite. Now he has complaints of
skin itch, weakness, furunculosis. His blood contains: glucose – 16 mmole/L, ketone bodies – 100
mcmole/L; glucosuria. What disease has developed?
A. Insulin-dependent diabetes
B. Insulin-independent diabetes
C. Steroid diabetes
D. Diabetes insipidus
E. Malnutrition diabetes
2. Examination of a patient revealed glycosuria 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?
A. Increased urine osmotic pressure
B. Decreased plasma oncotic pressure
C. Increased filtration pressure
D. Decreased cardiac output
E. Increased plasma oncotic pressure
3. A patient at the early stage of diabetes mellitus was found to have polyuria. What is its cause?
A. Hyperglycemia
B. Hypercholesterolemia
C. Hyperkaliemia
D. Hypocholesterolemia
E. Ketonemia
4. A comatose patient has been delivered to a hospital. He has a 5-year history of type 2 diabetes
mellitus. Objectively: breathing is deep and noisy, there is a smell if acetone around the patient.
The concentration of glucose in blood is 15,2 millimole/l, of ketone bodies – 100 micromole/l.
These disorders are typical for the following complication of this disease:
A. Ketoacidotic coma
B. Hyperglycemic coma
C. Hyperosmolar coma
D. Hepatic coma
E. Hypoglycemic coma
5. It is known that patients with diabetes mellitus are more subject to inflammative processes, they
have low regeneration and slower wound healing. What is the reason for this?
A. Decrease in protheosynthesis
B. Increase in lipolysis
C. Accelerated gluconeogenesis
D. Decrease in lipolysis
E. Intensification of catabolism
6. A female patient complains of vision impairment. On examination she was found to have
obesity, fasting hyperglycemia. What complication of diabetes can cause vision impairment?
A. Microangiopathy
B. Glomerulopathy
C. Macroangiopathy
D. Atherosclerosis
E. Neuropathy
7. A patient with insulin-dependent diabetes had an insulin injection. Sometime later he felt
weakness, irritability, excessive sweating. What is the main reason of these disorders?
A. Carbohydrate starvation of brain
B. Intensified glycogenolysis
C. Intensified ketogenesis
D. Intensified lypogenesis
E. Reduced glyconeogenesis
10. A patient with the symptoms of acute alcoholic poisoning was brought to the hospital. What
carbohydrates metabolism changes are typical for this condition?
A. The gluconeogenesis velocity in liver is decreased
B. The gluconeogenesis is increased in liver
C. The breakage of glycogen is increased in liver
D. The anaerobic glucose metabolism predominates in muscles
E. The anaerobic breakage of glucose is increased in muscles
11. After sprinting untrained people feel muscular pain as a result of lactate accumulation. I may
be connected with intensification of the following biochemical process:
A. Glycolysis
B. Glyconeogenesis
C. Pentose-phosphate cycle
D. Lipogenesis
E. Glycogenesis
12. A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger. Blood
test for sugar revealed hyperglycemia. What type of hyperglycemia is it?
A. Adrenal
B. Hypercorticoid
C. Alimentary
D. Somatotropic
E. Hypoinsulinemic
13. In patient hyperglycemia, glucosuria, polydipsia, polyphagia, and polyuria are revealed. What
hormone hyposecretion these changes develop due to?
A. Insulin
B. Atriopeptide
C. Glucagon
D. Antidiuretic hormone
E. Cortisone
14. A patient, aged 80, complains of increased appetite, thirst, enlarged urination, and worsening
of general condition after the taking some sweet food. What disease is it?
A. Diabetes mellitus
B. Hyperthyroidism
C. Hypothyroidism
E. Hypercortisolism
15. A patient, aged 50, complains of increased appetite, thirst, and loss of body weight, weakness.
At laboratory examination rise of amount of glucose in his blood revealed. What type of cells is
injured in case of this disease development?
A. B-cells of Langerhans islets
B. Thyrocytes
C. Lipotropocytes
D. A-cells of Langerhans islets
E. Pancreatocytes.
16. In 18-years-old patient, while laboratory examination presence of glucose in urine and normal
concentration of glucose in blood plasma were revealed. What disorder is the most possible cause
of these changes?
A. Disorders of tubular reabsorption
B. Disorders of tubular secretion
C. Disorders of glucocorticoids secretion
D. Disorders of insulin secretion
E. Disorders of glomerular filtration
A patient with diabetes mellitus suffers from persistently nonhealing surgical wound, which is a
sign of disrupted tissue trophism. What is the cause of such disorder?
A. Hypoglycemia
B. Increased lipid catabolism
C. Ketonemia
D. Anemia
E. Disruption of protein metabolism regulation
Examination of a 56-year-old woman with a history of type I diabetes mellitus revealed a disorder
of protein metaboli-sm that is manifested by aminoacidemia in the laboratory blood test values,
and cli-nically by the delayed wound healing and decreased synthesis of antibodies. Which of the
following mechanisms causes the development of aminoacidemia?
A. Increase in low-density lipoprotein level
B. Increase in the oncotic pressure in the blood plasma
C. Increased proteolysis
D. Decrease in the concentration of amino acids in blood
E. Albuminosis
Ketoacidosis that develops due to accumulation of ketone bodies in blood serum is a primary
complication of diabetes mellitus. What acid-base disbalance develops during this condition?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
E. -
According to the results of glucose tolerance test a patient has no disorder of carbohydrate
tolerance. Despite that glucose is detected in the patient’s urine (5 mmol/l). The patient has been
diagnosed with renal diabetes. What renal changes cause glucosuria in this case ?
A. Decreased activity of glucose reabsorption enzymes
B. Increased glucose secretion
C. Exceeded glucose reabsorption threshold
D. Increased glucose filtration
E. Increased activity of glucose reabsorption enzymes
WATER-ELECTROLYTIC METABOLISM
17. A patient was admitted to the infectious department. His symptoms: dry skin, decreased skin
turgor, rice-water stool. The patient was diagnosed with cholera. What disorder of water-
electrolytic balance is most often observed in this disease?
A. Isoosmotic hypohydration
B. Hyperosmotic hyperhydration
C. hypoosmotic hypohydration
D. Hyperosmotic hypohydration
E. Hypoosmotic hyperhydration
18. A patient with enteritis accompanied by massive diarrhea has low water rate in the extracellular
space, high water rate inside the cells and low blood osmolarity. What is such disturbance of water-
electrolytic metabolism called?
A. Hypo-osmolar hypohydration
B. Hyperosmolar hypohydration
C. Osmolar hypohydration
D. Hypo-osmolar hyperhydration
E. Hyperosmolar hyperhydration
19. A patient with enteritis accompanied with intense diarrhea has reduced quantity of water in the
extracellular space and increased quantity of water inside the cells as well as low blood
osmolarity. Name this disorder of water-electrolytic metabolism:
A. Hyposmolar hypohydration
C. Osmolar hypohydration
D. Hyposmolar hyperhydration
20. A woman with intractable vomiting was admitted to the infectious disease ward. What changes
of water-salt metabolism are likely to be observed?
A. Hypo-osmolar dehydration
B. Iso-osmolar dehydration
C. Hyperosmolar dehydration
D. Hypo-osmolar hyperdehydration
E. Hyper-osmolar hyperdehydration
21. A patient with a pathology of the cardiovascular system developed edemata of the lower
extremities. What is the mechanism of cardiac edema development?
A. Increased hydrostatic pressure at the venous end of the capillary
B. Increased oncotic pressure
C. Increased hydrostatic pressure at the arterial end of the capillary
D. Reduced osmotic pressure
E. Lymph efflux disorder
22. A 49-year-old woman spent a lot of time standing. As a result of it she got leg edema. What is
the most likely cause of the edema?
A. Increase in hydrostatic pressure of blood in veins
B. Decrease in hydrostatic pressure of blood in veins
C. Increase in systemic arterial pressure
D. Increase in oncotic pressure of blood plasma
E. Decrease in hydrostatic pressure of blood in arteries
23. A patient who suffers from heart failure has enlarged liver, edemata of lower extremities,
ascites. What is the leading mechanism in the development of this edema?
A. Hydrodynamic
B. Colloid osmotic
C. Lymphogenous
D. Membranogenic
E. –
24. Examination of experimental rats that have been getting only carbohydrate feed for a long time
revealed accumulation of water in tissues. What is the leading pathogenetic mechanism of
edema development?
A. Hypooncotic
B. Membranogenic
C. Dysregulatory
D. Lymphogenous
E. Hyperosmolar
25. Toxic pulmonary edema was reproduced on a laboratory rat by means of ammonium chloride
solution. What is the leading pathogenetic factor of this edema?
A. Increased permeability of capillars
B. Increase of venous outflow
C. Decrease of colloid osmotic pressure
D. Disorder of neural and humoral regulation
E. Increase of lymph outflow
26. Inflammation is characterised by increasing penetration of vessels of microcirculation stream,

increasing of their fluid dynamic blood pressure. Increasing of the osmotic concentration and
dispersity of protein structures 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
27. A typical symptom of cholera is great loss of water and sodium ions. What mechanism
underlies development of diarrhea in this case?
A. Activation of adenylate cyclase of enterocytes
B. Increased secretion of renin by the cells of renal arterioles
C. Aldosterone oxidation in adrenal cortex
D. Inhibition of vasopressin synthesis in hypothalamus
E. Increased corticotropin synthesis
28. A 45-year-old woman complains of strong general weakness, dyspnea, palpitation, feet edema,
increased size of abdomen. On examination: serious condition, respiration rate 32 per min,
cyanosis of face, lips, edema of feet, limbs, ascites, edema of anterior abdominal wall. Pulse 124
per min, BP 150/90 mm Hg. Liver is increased. Total serum protein - 70 g/L. What is the driving
member of edema pathogenesis in the patient?
A. Increase of hydrostatic pressure in capillaries
B. Increase of permeability of vessel wall
C. Increase of oncotic pressure of interstitial fluid
D. Hypoproteinaemia
E. Disorder of lymphatic drainage
29. On examination in patient the expressed swelling was found out in the field of the left forearm.
It developed after a bee sting. Name leading pathogenetic mechanism of the edema?
A. Membranogenous
B. Colloid
C. Osmotic
D. Lymphogenous
E. Hydrodynamic
30. The liquid was received from the patient with heart decompensation at a puncture of a belly
cavity, density ratio - 1012 albumine – 10g/l, globuline – 2g/l transparent citreous color, fibrinogen
is not present, single red blood cells, 1-3 leukocytes in sight. Name leading pathogenetic
mechanism of the edema?
A. Hydrodynamic
B. Membranogenous
C. Lymphogenous
D. Colloid
E. Osmotic
31. Gastric resection was done to a 35-years-old patient after ulcerous genesis stenosis of pylorus.
In 3 days after operation patient complains of intolerable thirst. Objectively: dryness of tongue and
mucous membrane of mouth, BP 110/70 mm Hg; hemoglobin, hematocrit and total serum protein
are normal. What alteration in water metabolis is likely to take place in this case?
A. Intracellular dehydration
B. Intracellular hyperhydration
C. Extracellular dehydration
D. Extracellular hyperhydration
E. Total dehydration
32. 40-years-old patient complains of total weakness, breathlessness, palpitation, feet swellings,
increasing of belly. Objectively: resperation rate 32 per min, cyanotic face, ascitis, liver is
increased, pulse 124 per min, BP 170/90 mmHg. Total serum protein 70 g/L. What is the leading
pathogenesis factor in the patient?
A. Increasing of hydrostatic blood pressure in capillars
B. Increasing of permeability of vessel wall
C. Increasing of oncotic pressure if transcellular fluid
D. Disorder of lymphatic drainage
E. Lipoproteinemia
33. In a patient, who used plant food for a long time, swellings have appeared. What is the direct
cause of this condition?
A. Hypoproteinemia
B. Hypoaminoacidemia
C. Decreasing of blood amount of microelements
D. Hypoglycemia
E. Anemia
34. Dehydration appears in patients with diabetes incipidus and in patient with forced perspiration
or stomach secretion. In both cases debit of water excesses debit of electrolytes. Changes of what
of the following rates will have the same directions in those pathologies?
A. Blood osmolarity
B. Circulatory volume
C. Concentration of sodium in urine
D. Urine osmolality
E. Concentration of sodium in blood
35. Patient has severe nephropathia with massive edematous syndrome complicated with chronic
bronchiectasis dicease. The following characteristics have been found by taking measurements:
heavy proteinuria, cylindruria, heavy serum protein decrease, hyperlipemia, hypokaliemia and
other. What is the initial and significal event in swelling pathogenesis in this patient?
A. Blood oncotic pressure decrease
B. Blood hydrodynamic pressure increase
C. Extracellular fluid pressure increase
D. Limphatic flow block
E. Microvessels permeability increase
36. Lung edema appeared in a patient with hypertensive crisis. What is the main factor in the
pathogenesis of this condition&
A. Pulmonary vessels hydrodynamic pressure increase
B. Pulmonary vessels permeability increase
C. Blood pressure increase
D. Pulmonary vessels resistance increase
E. Blood oncotic pressure decrease
37. What process is not important in the pathogenesis of swelling?

A. Blood oncotic pressure increase
B. Tissue oncotic pressure increase
C. Tissue osmotic pressure increase
D. Blood osmotic pressure decrease
E. Capillar hydrostatic pressure increase
38. Thirst appeared in 'hot shop' worker as a result of forced perspiration. Worker quenched thirst
with water without salt. What kind of water-salt alteration could be in this case?
A. Hypoosmolar hypohydria
B. Hyperosmolar hyperhydration
C. Hyperosmolar hypohydration
D. Isoosmolar hypohydration
E. Hypoosmolar hyperhydria
39. Clinical signs of lung edema appeared in a patient with left-heart failure. What pathogenic
mechanism is the initial in this case?
A. Hydrodynamic
B. Colloid-osmotic
C. Lymphagenic
D. Membranogenous
E. Congestive
40. A 72-years-old patient 8 years has essential hypertension. Last 3 weeks he has such sighs of
enterocolitis as intensive and frequent diarrhea. Swellings on the face and limbs appeared. What
is the cause of swellings?
A. Hypoproteinemia
B. Na reabsorbtion decrease
C. Arterial hypertension
D. Dehydration
E. Venous pressure increase
41. Swellings are marked in a patient as a result of kidney disease. There is significance amount
of protein in urine analysis. What mechanism could explain swellings appearing in this patient?
B. Kidney filtration pressure decrease
C. Lymphatic oncotic pressure decrease
D. Interstitial oncotic pressure decrease
E. Blood osmotic pressure increase
30 minutes after drinking mango juice a child suddenly developed a local swelli-ng in the area of
the soft palate, which impeded swallowing and, eventually, res ration. Mucosa of the swollen area
was hyperemic and painless. Blood test revealed moderate eosinophilia. Body temperature was
normal. Anamnesis states that the elder sister of the child has been suffering from bronchial asthma
attacks. What kind of edema has developed in the child?
A. Inflammatory
B. Hepatic
C. Cardiac
D. Alimentary
E. Allergic
A 19-vear-old young man has been examined in a nephrological hospital. Increased potassium
content was detected in secondary urine of the patient. Such changes have been most likely caused
by the increased secretion of the following hormone:
A. Glucagon
B. Aldosterone
C. Testosterone
D. Adrenalin
E. Oxytocin
ACID-BASE METABOLISM
42. Disorder of the airways passage in small and middle bronchi was revealed in the patient. What
disorder of the acid-base equilibrium can be detected in the blood?
A. Respiratory acidosis
B. Metabolic acidosis
C. Respiratory alkalosis
D. Metabolic alkalosis
E. –
43. A patient with respiratory failure has blood pH of 7,35. pCO2 test revealed hypercapnia.
Urine pH test revealed an increase in the urine acidity. What form of acid-base imbalance is the
case?
A. Compensated respiratory acidosis
B. Compensated metabolic acidosis
C. Decompensated metabolic acidosis
D. Compensated respiratory alkalosis
E. Decompensated respiratory alkalosis
44. A patient with diabetes developed a diabetic coma due to the acid-base imbalance. Specify the
kind of this imbalance:
A. Metabolic acidosis
D. Gaseous alkalosis
E. Non-gaseous alkalosis
45. Prophylactic examination of a patient revealed hyperglycemia, ketonuria, polyuria, glycosuria.

What form of acid-base balance disorder is the case?
B. Gaseous acidosis
C. Nongaseous acidosis
E. Metabolic alkalosis
46. A 30-year-old comatous patient with type I diabetes mellitus had been admitted to a hospital.
Laboratory tests revealed hyperglycemia, ketonemia. Which of the following metabolic disorders
might be found in this patient?
C. Normal acid-base state
D. Respiratory acidosis
E. Respiratory alkalosis
47. After taking poor-quality food a patient developed repeated episodes of diarrhea. On the next
day he presented with decreased arterial pressure, tachycardia, extrasystole. Blood pH is
7,18. These abnormalities were caused by the development of:
A. Nongaseous acidosis
B. Gaseous acidosis
C. Nongaseous alkalosis
48. As a result of improper feeding an infant got full-blown diarrhea. One of its main consequences
is excretion of large amount of sodium bicarbonate. What form of acid-base balance
disturbance is it?
A. Excretory acidosis
D. Respiratory alkalosis
E. Acid-base balance won't be disturbed
49. A man is in the state of rest. He has been forcing himself to breath deeply and frequently for
3-4 minutes. What effect will it have upon acid-base balance of the organism?
C. Metabolic acidosis
E. There will be no change in acid-base balance
50. A newborn child with pylorostenosis has often repeating vomiting accompanied by apathy,
weakness, hypertonicity, sometimes convulsions. What disorder form of acid-base balance is it?
A. Nongaseous alkalosis
B. Gaseous alkalosis
C. Gaseous acidosis
D. Metabolic acidosis
E. Excretory acidosis
51. A pregnant women developed severe toxemia with exhausting recurrent vomiting throughout
a day. By the end of the day she developed tetanic convulsions and bodily dehydration. The
described changes were caused by the following type of acid-base disbalance:
A. Nongaseous excretory alkalosis
B. Gaseous alkalosis
C. Gaseous acidosis
D. Nongaseous metabolic acidosis
E. Nongaseous excretory acidosis
52. An infant has pylorospasm, weakness, hypodynamia, convulsions as a result of frequent

vomiting. What kind of acid-base disbalance is it?
A. Excretory alkalosis
B. Excretory acidosis
C. Metabolic acidosis
D. Exogenous nongaseous acidosis
E. Gaseous alkalosis
53. A patient suffering from a respiratory failure has the blood pH level of 7.35. Hypercapnia was
diagnosed on the basis of his РаСО2 rate measurements. An increase in his urine pH was found
when measured. Which of the following types of acid-base balance disorders is likely to take place
in this case?
С. Excretory alkalosis
54. A patient with food toxicoinfection accompanied by profuse diarrhea suffers a severe condition
attended with impairment of consciousness and Kussmaul's breathing. The blood test showed the
pH level of 7.3. A substantial drop of base fund (i.e. a base deficit) in blood is observed. The urine
is in a strong acid condition; containing excessive phosphates and ammonium salts. Which of the
following types of acid-base balance disorders is likely to take place in this case?
C. Excretory alkalosis
55. A patient suffering from the mountain disease which develops has the compensatory
hyperventilation in his lungs. Which of the following types of acid-base balance disorders is likely
to take place in this case?
56. Hypercapnia was found in patient's blood when tested for CO2 content which caused a
bronchial asthma attack. Which of the following types of acid-base balance disorders is likely to
take place in this case?
57. A patient suffers from disrupted patency of the airways at the level of small and medium-
sized bronchial tubes. What changes of acid-base balance can occur in the patient?
C. Respiratory alkalosis
D. Acid-base balance remains unchanged
E. Metabolic acidosis
58. Due to recurring vomiting a patient has lost significant amount of gastric juice, which led to
development of acid-base dysbalance. What type of acid-base dysbalance has developed?
B. Nongaseous alkalosis
C. Gaseous acidosis
D. Nongaseous acidosis
E. Gaseous alkalosis
STARVATION
59. A chemical burn caused esophagus stenosis. Difficulty of ingestion led to the abrupt loss of
weight. In blood: 3,0×1012/l, Hb – 106 g/l, crude protein – 57 g/l. What type of starvation is it?
A. Incomplete
B. Proteinic
C. Complete
D. Water
E. Absolute
60. Examination of a 40-year-old man ill with stenosing (without metastases) esophageal
carcinoma revealed the following changes: atrophy of skeletal muscles and fatty tissue. His skin
is sallow, epidermis is attenuated, heart has grown smaller. Myocardium and liver are brown. What
is the most probable diagnosis?
A. Alimentary cachexia
B. Brown atrophy
C. Cancerous cachexia
D. Addison's disease
E. Myasthenia
61. A 45-years-old taking course of nestiatria in the clinic because of obesity. 4 day of starvation
- sense of hunger saved, general weakness, depression, heavy weight loss. Blood glucose
2.9mmol/L. Urine nitrogen 10g/day. Respiratory quotient 0,9. What pathophysiologyc period of
starvation is a patient in?
A. Non-economical energy loss
B. Maximal adaptation
C. Depression
D. Terminal
E. Indifference
62. On 7th day of starvation with water in rats loss of 45% body weight is observed. Respiratory
quotient is 0.8. Some animals have keratitis local necrosis of skin. Rats are very inhibited. What
is the period of starvation in this case?
A. Tissue destruction, intoxication and death
B. Excitation
C. Depression
D. Indifference
E. Paralyses and death
63. A 28-years-old patient with average body structure has hungered for 48 hours. What substrates
are used by muscles as energy source in the case?
A. Glucose
B. Aminoacids
C. Ketonic bodies and fatty acids
D. Lactate
E. Pyruvate
64. Fasting edemas appear in continuous starvation. What is the cause of this phenomenon?
B. Blood osmotic pressure decrease
C. ADH secretion increase
D. ADH secretion decrease
E. Blood oncotic pressure increase
65. A patient with esophagus tumor hasn't eaten for a week. What is the change of his hormonal
states?
A. Glucagon secretion increase
B. Insulin secretion increase
C. Cortisol secretion decrease
D. Adrenalin secretion decrease
E. Tyroxin secretion increase
66. On examination a 50-years-old woman has hypothermia, hypotension, muscle weakness,

negative nitric balance. The woman has used plant diet for a long time. What is the cause of her
condition?
A. Not enough amount of proteins in a ration
B. Not enough amount of carbohydrates in a ration
C. Excessive consumption of water
D. Not enough amount of fat in a ration
E. Excessive amount of carbohydrates in a ration
67. A patient has pylorostenosis which make eating more difficult. Loss of weight, muscle
weakness and low limbs edemas are observed. What is the form of starvations in this case?
A. Non-absolute starvation
B. Water starvation
C. Absolute starvation
D. Partial (protein) starvation
E. Absolute starvation with water
68. In the experimental absolute starvation with water insufficient is compensated partially by
endogenous water formation. What matter does give the largest amount of oxidative water during
oxidation?
A. Fats
B. Glucose
C. Glycerin
D. Glycogen
E. Protein
69. Adaptive changes of metabolism and switch on the endogenous feeding develop in starvation.
What is supposed to be most likely on the 8l day of absolute starvation in an adult man?
A. Decrease of ammonium salts excretion with urine
B. Inhibition of gluconeogenesis in kidneys
C. Intensive ketogenesis in the liver
D. Decrease of lipolysis in the fat tissue
E. Respiratory quotient is 0.9
70. Rats are in experimental absolute starvation. Animals are motionless, respiration retarded, they
don't take forecast. Standard metabolism is decreased on 10%. Respiratory quotient is 0.7.
Nitrogen balance is negative. Hyperlipacidemia. What is the period of starvation?
A. Maximal adaptation
B. Non-economical energy loss
C. Depression
D. Terminal
E. Indifference
71. Glucose content of blood keeps at sufficient level after one week of starvation. Is it caused by
activation of the following process:
A. Glycogenolysis
B. Glycogen phosphorolysis
C. Gluconeogcnesis
D. Tricarboxylic acid cycle
E. Glycolysis
72. A victim of an earthquake has been remaining under debris for 7 days without food or water.
What type of starvation is it?
A. Complete
B. Qualitative
C. Complete with continued hydration
D. Incomplete
E. Quantitative
PROTEIN METABOLISM
73. A patient being treated for viral hepatitis type B got symptoms of hepatic insufficiency. What
blood changes indicative of protein metabolism disorder will be observed in this case?
A. Absolute hypoalbuminemia
B. Absolute hyperalbuminemia
C. Absolute hyperfibrinogenemia
D. Proteinic blood composition is unchanged
E. Absolute hyperglobulinemia
74. Toxic affection of liver results in dysfunction of protein synthesis. It is usually accompanied
by the following kind of dysproteinemia:
A. Absolute hypoproteinemia
B. Absolute hyperproteinemia
C. Relative hypoproteinemia
D. Paraproteinemia
E. Relative hyperproteinemia
75. There are several groups of molecular mechanisms playing important part in pathogenesis of
insult to cells which contributes to the pathology development. What processes are stimulated by
proteinic damage mechanisms?
A. Enzyme inhibition
B. Lipid peroxidation
C. Phospholipase activation
D. Osmotic membrane distension
E. Acidosis
76. Examination of a 45-year-old man who had kept to a vegeterian diet for a long time revealed
negative nitrogen balance. Which peculiarity of his diet is the cause of this phenomenon?
A. Lack of proteins
B. Excess of water
C. Excess of carbohydrates
D. Lack of fats
E. Lack of vitamins
77. A 60-years-old patient consulted the doctor with complaints of pain in small joints of feet and
hands. Joints are enlarged, look like thickened nodes. Serum urates are increased. What matter
disorder could be reason of development of this state?
A. Purines
B. Amino acid
C. Pirimidins
D. lipids
E. Carbonhydrates
78.A 65-years-old man consulted the doctor with complaints of acute pain in the big toes. He likes
and often drink beer. Gout is suspected. What analisis could be useful for diagnosis confirmation?
A. Urinary acid
B. Bilirubin
C. Ketonic bodies
D. Urea
E. Lactate
79. On examination the diagnosis of alkaptonuria was made. Deficit of what enzyme is the couse
of this disease?
A. Phenilalaninehydroxilase
B. Tyroxinehydroxilase
C. Tyrosinase
D. Monoaminoxidase
E. Galactose
80. Patient has protein in plasma 35g/l. He had resection of significant segment of intestine a month
ago. What is the change of plasma protein content in this case?
A. Hypoproteinemia
B. Hyperproteinemia
C. Paraproteinemia
D. Dysproteinemia
E. Hypernitrogenemia
81. A patient with fever has lost body weight during three weeks. Rest nitrogen 50 mmol/L. What
nitrogen balance does have a patient?
A. Negative
B. Positive
C. Normal
D. Relative
E. -
82. In a patient with the infectious disease concentration of blood protein 120g/l. What is the
quantitative change of blood protein in this case?
A. Hyperproteinemia
B. Hypoproteinemia
C. Paraproteinemia
D. Dysproteinemia
83. In a patient with a hepatic coma content of total protein in blood 40g/l, content of albumins
and fibrinogen was decreased, gamma-globulin was increased. What is the change of high-quality
protein composition in blood in this case?
A. Hypoproteinemia
B. Hyperproteinemia
C. Paraproteinemia
D. Dysproteinemia
FAT METABOLISM
84. A 58-year-old patient suffers from the cerebral atherosclerosis. Examination revealed
hyperlipoidemia. What class of lipoproteins will most probably show increase in concentration in
this patient’s blood serum?
A. Low-density lipoproteins
B. High-density lipoproteins
C. Fatty acid complexes with albumins
D. Chylomicrons
E. Cholesterol
85. A 70-year-old man is ill with vascular atherosclerosis of lower extremities and coronary heart
disease. Examination revealed disturbance of lipidic blood composition. The main factor of
atherosclerosis pathogenesis is the excess of the following lipoproteins:
A. Low-density lipoproteins
B. Cholesterol
C. High-density lipoproteins
D. Intermediate density lipoproteins
E. Chylomicrons
VITAMIN METABOLISM
86. Pyruvate concentration in the patient’s urine has increased 10 times from normal amount. What
vitamin deficiency can be the reason of this change:
A. Vitamin B1
B. Vitamin C
C. Vitamin A
D. Vitamin E
E. Vitamin B6
87. What vitamin deficiency leads to both disorder of reproductive function and distrophy of
skeletal muscles?
A. Vitamin E
B. Vitamin A
C. Vitamin K
D. Vitamin D
E. Vitamin B1
88. A 10-year-old girl has a history of repeated acute respiratory viral infection. After recovering
she presents with multiple petechial hemorrhages on the sites of friction from clothing rubbing the
skin. What kind of hypovitaminosis has this girl?
A. C
B. B2
C. B1
D. B6
E. A
89. A 20-year-old male patient complains of general weakness, rapid fatigability, irritability,
decreased performance, bleeding gums, petechiae on the skin. What vitamin deficiency may be a
cause of these changes?
A. Ascorbic acid
B. Folic acid
C. Thiamine
D. Riboflavin
E. Retinol
90. Ketosis develops in the patients with diabetes mellitus, as the result of activation of fatty acids
oxidation processes. What acid- base imbalance can result from accumulation of excessive ketone
bodies in the blood?
B. No imbalance occurs
C. Metabolic alkalosis
91. A woman with hypophyseal diabetes insipidus developed a water-mineral imbalance. What
type of water-mineral imbalance develops in such cases?
A. Hyperosmolar hyperhydration
B. Isoosmolar dehydration
C. Hypoosmolar hyperhydration
D. Hyperosmolar dehydration
E. Hypoosmolar dehydration
92. A patient with a chemical burn has developed esophageal stenosis. The patient presents with
acute weight loss due to problematic food intake. Blood test: erythrocytes - 3.0 · 1012/L, Hb- 106
g/L, total protein - 57 g/L. What type of starvation does this patient suffer from?
A. Incomplete starvation
B. Complete starvation
C. Water starvation
D. Protein starvation
E. Absolute starvation
93. A woman with enteritis accompanied by severe diarrhea presents with loss of water in the
extracellular space, increased water content in the cells, and decreasing blood osmolarity. Name
this type of water- electrolyte imbalance:
A. Hypoosmolar hypohydration
C. Isoosmolar hypohydration
D. Hyperosmolar hyperhydration
E. Hypoosmolar hyperhydration
94. A 50-year-old inpatient during examination presents with glucosuria and blood glucose of 3.0
mmol/L, which are the most likely to be caused by:
A. Renal disorder
B. Pellagra
C. Diabetes insipidus
D. Myxedema
E. Essential hypertension
95. A 40-year-old man with impaired venous patency in the lower limbs developed edemas. What
mechanism plays the main role in the development of this disturbance?
A. Positive fluid balance
B. Disturbed humoral regulation of water-mineral balance
C. Elevated filtration pressure
D. Hypoproteinemia
E. Decreased gradient of osmotic pressure between blood and tissue
96. A 45-year-old woman exhibits no sings of diabetes mellitus, but her fasting blood glucose
levels are elevated (7.2 mmol/L). What should be measured next?
A. Residual blood nitrogen
B. Blood urea
C. Glycated hemoglobin
D. Urine glucose
E. Glucose tolerance
97. Toxic damage to hepatic cells resulted in disruption of the patient`s livers function and the
patient developed edemas. What changes of blood plasma are the main cause of edema
development?
A. Decrease of albumin content
B. Increase of albumin content
C. Decrease of globulin content
D. Increase of globulin content
E. Decrease of fibrinogen content
98. A patient with diabetes mellitus after an insulin injection lost his consciousness and developed
convulsions. What will be the result of a biochemical test for blood glucose level in this case?
A. 2.5 mmol/L
B. 5.5 mmol/L
C. 8.0 mmol/L
D. 3.3 mmol/L
E. 10 mmol/L
99. A 3-year-old child has been brought by ambulance to the intensive care unit of the infection
diseases hospital. On examination the child is in severe condition, skin and mucosa are dry, tissue
turgor is reduced. The patient's history states that profuse diarrhea and recurrent vomiting were
observed throughout the previous day after the child had eaten food products of poor quality. What
type of salt and water imbalance is likely to have developed in the patient?
A. Isoosmolar hyperhydration
B. Hypoosmolar hyperhydration
C. Hypoosmolar dehydration
D. Isoosmolar dehydration
100. A 16-year-old girl, who has been starving herself for a long time lose weight, developed an
edema. This phenomenon is mainly caused by:
A. Decreased production of vasopressin in the hypothalamus
B. Hypoglycemia due to glycogen synthesis disturbance
C. Deceleration of glomerular filtration rate
D. Venous congestion and increased venous pressure
E. Hypoproteinemia due to protein synthesis disturbance
101. A 56-year-old man with a valvular defect complains of lower limb edemas that lately
increased in frequency. Name the local pathogenetic factor of edema development in this case:
A. Decrease of vessel wall permeability
B. Increase of hydrodynamic blood pressure
C. Decrease of hydrodynamic blood pressure
D. Increase of oncotic blood pressure
E. Increase of interstitial pressure
1. A 32-year-old patient was admitted to the hospital with gross blood loss due to auto accident
trauma. Ps – 110 Bpm, RR- 22 pm, BP- 100/60 mm Hg. What changes in the blood will occur in
an hour after the blood loss?
A. Hypovolemia
B. Erythropenia
C. Hypochromia of erythrocytes
D. Leukopenia
E. Hypoproteinemia
2. A 26-year-old pregnant woman is under treatment at an in-patient hospital. After a continuous

attack of vomiting she was found to have reduced volume of circulating blood. What kind of
change in general blood volume is the case?
A. Polycythemic hypovolemia
B. Oligocythemic hypervolemia
C. Polycythemic hypervolemia
D. Simple hypovolemia
E. Oligocythemic hypovolemia
3. In a car accident a man got injured and lost a lot of blood. What changes in peripheral blood
are most likely to occur on the 2nd day after the injury?
A. Erythropenia
B. Microplania
C. Anisocytosis
D. Hypochromia
E. Significant reticulocytosis
4. On the fifth day after the acute blood loss a patient has been diagnosed with hypochromic
anemia. What is the main mechanism of hypochromia development?
A. Release of immature red blood cells from the bone marrow
B. Increased destruction of red blood cells in the spleen
C. Increased excretion of body iron
D. Impaired iron absorption in the intestines
E. Impaired globin synthesis
Erythrocytosis. Anemia: definition, general clinical and hematological appearance.

Posthemorrhagic anemia
5. A 46-year-old female patient complaining of having alveolar haemorrhage for 6 hours after a
tooth extraction, general weakness and dizziness was delivered to a hospital. The patient has a
history of essential hypertension. Objectively: pale skin and mucous membranes. In blood: Hb -
80 g/l, Ht - 30%, bleeding and coagulation time is normal. What complication had been provoked
by the haemorrhage?
A. Acute posthaemorrhagic anaemia
B. Iron deficiency anaemia
C. Folic acid deficiency anaemia
D. Haemolytic anaemia
E. Chronic posthaemorrhagic anaemia
6. A 42 year old patient complains of pain in the epigastral area, vomiting; vomit masses have the
colour of “coffee-grounds”, the patient has also melena. Anamnesis records gastric ulcer. Blood
formula: erythrocytes - 2,8*1012/l, leukocytes – 8*109/l, Hb- 90 g/l. What complication is it?
A. Haemorrhage
B. Penetration
C. Perforation
D. Canceration
E. Pyloric stenosis
7. A 55 y.o. woman consulted a doctor about having continuous cyclic uterine hemorrhages for a
year, weakness, dizziness. Examination revealed skin pallor. Hemogram: Hb- 70 g/l,
erythrocytes - 3,2*1012/l, color index - 0,6, leukocytes - 6,0*109/l, reticulocytes - 1%; erythrocyte
hypochromia. What anemia is it?
A. Chronic posthemorrhagic anemia
B. Hemolytic anemia
C. Aplastic anemia
D. B12-folate-deficiency anemia
E. Iron-deficiency anemia
8. A 30-year-old patient’s blood test revealed the following: erythrocyte count is 6 ∙ 1012/l,
hemoglobin is 10,55 mmol/l. Vaquez’s disease was diagnosed. Name the leading part of
pathogenesis:
A. B12-deficiency
B. Iron-deficiency
C. Neoplastic erythroid hyperplasia
D. Hypoxia
E. Acidosis
Anemia, witch duo to disturbances of erythropoiesis

9. A 58-year-old female patient complains of rapid fatigability, performance decrement,
sleepiness, dyspnea during fast walking. In blood: RBCs - 4,0*1012/l, Hb - 80 g/l, CI - 0,6; alurge
number of annulocytes and microcytes. What anaemia are these presentations typical for?
A. Iron-deficient
B. Posthemorrhagic
C. Sickle-cell
D. Pernicious
E. Haemolytic
10. A 15 year old girl has pale skin, glossitis, gingivitis. Blood count: erythrocytes - 3,3*1012/l,
hemoglobin - 70 g/l, colour index - 0,5. Examination of blood smear revealed hypochromia,
microcytosis, poikilocytosis. What type of anemia is it?
A. Iron-deficient
B. B12-folic acid-deficient
C. Sickle-cell
D. Hemolytic
E. Thalassemia
11. Patient with hypochromic anemia has splitting hair and loss of hair, increased nail brittling and
taste alteration. What is the mechanism of the development of these symptoms?
A. Deficiency of iron-containing enzymes
B. Deficiency of vitamin В12
C. Decreased production of parathyrin
D. Deficiency of vitamin А
E. Decreased production of thyroid hormones
12. 2 years ago a patient underwent resection of pyloric part of stomach. He complains of
weakness, periodical dark shadows beneath his eyes, dyspnea. In blood: Hb - 70 g/l, erythrocytes
- 3,0*1012/l, colour index - 0,7. What changes of erythrocytes in blood smears are the most typical
for this condition?
A. Microcytes
B. Megalocytes
C. Schizocytes
D. Ovalocytes
E. Macrocytes
13. A patient is diagnosed with iron-deficiency sideroachrestic anemia, progression of which is

characterised by skin hyperpigmentation, pigmentary cirrhosis, heart and pancreas affection. Iron
level in the blood serum is increased. What disorder of iron metabolism causes this disease?
A. Failure to assimilate iron leading to iron accumulation in tissues
B. Excessive iron intake with food
C. Disorder of iron absorption in bowels
D. Increased iron assimilation by body
E. –
14. A 37-year-old female patient complains of headache, vertigo, troubled sleep, numbness of
limbs. For the last 6 years she has been working at the gas-discharge lamp-producing factory in
the lead-processing shop. Blood test findings: low hemoglobin and RBC level, serum iron
concentration exceeds the norm by several times. Specify the type of anemia:
A. Iron refractory anemia
B. Iron-deficiency anemia
C. Minkowsky-Shauffard disease
D. Hypoplastic anemia
E. Metaplastic anemia
15. A year after subtotal stomach resection on account of ulcer of lesser curvature the following
blood changes were revealed: anemia, leukocytopenia and thrombocytopenia, color index – 1,3,
megaloblasts and megalocytes. What factor deficiency caused the development of those
pathology?
A. Castle’s factor
B. Hydrochloride acid
C. Mucin
D. Pepsin
E. Gastrin
16. Blood test of a patient suffering from atrophic gastritis gave the following results: RBCs -
2,0*1012/l, Hb - 87 g/l, colour index - 1,3, WBCs - 4,0*109/l, thrombocytes – 180*109/l. Anaemia
might have been caused by the following substance deficiency:
A. Vitamin B12
B. Vitamin K
C. Iron
D. Vitamin A
E. Zinc
17. A 50-year-old patient has been examined by a dentist and found to have crimson smooth
tongue. Blood analysis revealed a decrease in RBC level and hemoglobin concentration, colour
index of 1,3, symptoms of megaloblastic hematopoiesis, degenerative changes in WBCs. What
blood disorder was found in this patient?
A. B12-folic-acid-deficiency anemia
B. Hemolytic anemia
C. Myeloid leukemia
D. Iron deficiency anemia
E. Aplastic anemia
18. A 56 year old man was taken to the hospital with complaints of general weakness, pain and
burning in the region of tongue, extremity numbness. In the past, he had resection of cardiac part
of ventricle. Blood test: Hb- 80 g/L; RBC- 2,0*1012/L; colour index of blood- 1,2; leukocytes -
3,5*109/L. What type of anemia is it?
A. В12 folic-deficient
B. Hemolytic
C. Posthemorrhagic
D. Aplastic
E. Iron-deficient
19. A patient is diagnosed with chronic atrophic gastritis attended by deficiency of Castle’s
intrinsic factor. What type of anemia does the patient have ?
A. Protein-deficiency anemia
B. Hemolytic anemia
C. B12-deficiency anemia
D. Iron-deficiency anemia
E. Iron refractory anemia
A patient has been diagnosed with severe Bi2-deficient anemia with hemopoiesis. Anamnesis
states total gastrectomy. What cells allow to confirm this diagnosis, if they are absent in the
peripheral blood?
A. Microcytes
B. Megalocytes
C. Normocytes
D. Ovalocytes
E. Anulocytes
Hemolytic anemia
20. Examination of a 52-year-old female patient has revealed a decrease in the amount of red blood
cells and an increase in free hemoglobin in the blood plasma (hemoglobinemia). Color index is
0.85. What type of anemia is being observed in the patient?
A. Acquired hemolytic
B. Hereditary hemolytic
C. Acute hemorrhagic
D. Chronic hemorrhagic
E. Anemia due to diminished erythropoiesis
21. A 19 year old patient was diagnosed with chronic acquired hemolytic anemia. What is the
leading pathogenetic mechanism of this pathology's development?
A. Autoimmune hemolysis
B. Toxic hemolysis
C. Intracellular hemolysis
D. Hyposmolarity of plasma
E. Osmotic hemolysis
22. Substitution of the glutamic acid on valine was revealed while examining initial molecular
structure. For what inherited pathology is this typical?
A. Sickle-cell anemia
B. Thalassemia
D. Favism
E. Hemoglobinosis
23. A 19-year-old female patient has had low haemoglobin rate of 90-95 g/l since childhood. Blood
count results obtained after hospitalisation are as follows: erythrocytes - 3,2*1012/l, Hb- 85 g/l,
colour index - 0,78; leukocytes - 5,6*109/l, platelets – 210*109/l. Smear examination revealed
anisocytosis, poikilocytosis and target cells. Reticulocyte rate is 6%. Iron therapy was ineffective.
What blood pathology corresponds with the described clinical presentations?
A. Thalassemia
B. Membranopathy
C. Favism
D. Sickle-cell anemia
E. Enzymopathy
24. A 25 year old Palestinian woman complains of weakness, dizziness, dyspnea. In anamnesis:
periodically exacerbating anemia. In blood: Hb - 60 g/l, erythrocytes - 2,5*1012/l, reticulocytes -
35‰, anisocytosis and poikilocytosis of erythrocytes, a lot of target cells and polychromatophils.
What type of anemia is it?
A. Thalassemia
B. Sickle-cell anemia
D. Addison-Biermer disease
E. Glucose 6-phosphate dehydrogenase-deficient anemia
25. A 34 year old woman was diagnosed with hereditary microspherocytic hemolytic anemia
(Minkowsky-Shauffard disease). What mechanism caused haemolysis of erythrocytes?
A. Membranopathy
B. Enzymopathy
C. Hemoglobinopathy
D. Autoimmune disorder
E. Bone marrow hypoplasia
26. As a result of increased permeability of the erythrocyte membrane in a patient with

microspherocytic anaemia (Minkowsky-Shauffard disease) cells receive sodium ions and water.
Erythrocytes take form of spherocytes and can be easily broken down. What is the leading
mechanism of erythrocyte damage in this case?
A. Electrolytic osmotic
B. Calcium
C. Acidotic
D. Protein
E. Nucleic
27. Biochemical analysis of an infant’s erythrocytes revealed evident glutathione peroxidase

deficiency and low concentration of reduced glutathione. What pathological condition can develop
in this infant ?
A. Sicklemia
B. Pernicious anemia
C. Megaloblastic anemia
D. Hemolytic anemia
E. Iron-deficiency anemia
Leukocytosis. Leukopenia
28. Two hours after an exam a student had a blood count done and it was revealed that he had
leukocytosis without significant leukogram modifications. What is the most probable mechanism
of leukocytosis development?
A. Redistribution of leukocytes in the organism
B. Leukopoiesis intensification
C. Deceleration of leukocyte lysis
D. Deceleration of leukocyte migration to the tissues
E. Leukopoiesis intensification and deceleration of leukocyte lysis
29. 24 hours after appendectomy blood of a patient presents neutrophilic leukocytosis with
regenerative shift. What is the most probable mechanism of leukocytosis development?
A. Amplification of leukopoiesis
B. Redistribution of leukocytes in the organism
C. Decelerated leukocyte destruction
D. Decelerated emigration of leukocytes to the tissues
E. Amplification of leukopoiesis and decelerated emigration of leukocytes to the tissues
30. Examination of a patient admitted to the surgical department with symptoms of acute
appendicitis revealed the following changes in the white blood cells: the total count of leukocytes
is 16*109/l. Leukocyte formula: basophils - 0, eosinophils - 2%, juvenile forms - 2%, stabnuclear
- 8%, segmentonuclear - 59%, lymphocytes - 25%, monocytes- 4%. The described changes can be
classified as:
A. Neutrophilia with regenerative left shift
B. Neutrophilia with right shift
C. Neutrophilia with degenerative left shift
D. Neutrophilic leukemoid reaction
E. Neutrophilia with hyperregenerative left shift
31. After an attack of bronchial asthma a patient had his peripheral blood teste d. What changes
can be expected?
A. Eosinophilia
B. Lymphocytosis
C. Erythrocytosis
D. Thrombocytopenia
E. Leukopenia
32. A 3-year-old child had eaten some strawberries. SeSon he developed a rash and itching. What
was found in the child’s leukogram?
A. Eosinophilia
B. Hypolymphemia
C. Lymphocytosis
D. Monocytosis
E. Neutrophilic leukocytosis
33. A 5 year old child is ill with measles. Blood analysis revealed increase of total number of
leukocytes up to 13*109/l. Leukogram: basophils - 0, eosinophils - 1, myelocytes - 0, juvenile
neutrophils - 0, band neutrophils - 2, segmented neutrophils - 41, lymphocytes - 28, monocytes -
28. Name this phenomenon:
A. Monocytosis
B. Agranulocytosis
C. Lymphocytosis
D. Eosinopenia
E. Neutropenia
34. As a result of a road accident a 26-year-old man is in the torpid phase of shock. Blood count:
leukocytes - 3,2*109/l. What is the leading mechanism of leukopenia development?
A. Leukocyte redistribution in the bloodstream
B. Faulty release of mature leukocytes from the bone marrow into the blood
C. Leukocyte destruction in the hematopietic organs
D. Leukopoiesis inhibition
E. Increased excretion of the leukocytes from the organism
35. A 26-year-old man is in the torpid shock phase as a result of a car accident. In blood: 3,2*109/l.
What is the leading mechanism of leukopenia development?
A. Redistribution of leukocytes in bloodstream
B. Disturbed going out of mature leukocytes from the marrow into the blood
C. Leikopoiesis inhibition
D. Lysis of leukocytes in the blood-forming organs
E. Intensified elimination of leukocytes from the organism
36. Parents of a 3-year-old child have been giving him antibiotics with purpose of preventing
enteric infections for a long time. A month later the child’s condition changed for the worse. Blood
examination revealed apparent leukopenia and granulocytopenia. What is the most probable
mechanism of blood changes?
A. Myelotoxic
B. Autoimmune
C. Redistributive
D. Age-specific
E. Hemolytic
37. A 23-year-old patient with acute pulpitis has elevated body temperature and an increase in the
WBC count up to 14 • 109/L. The leucogram is as follows: basophils - 0, eosinophils - 2,
monocytes - 0, immature neutrophils - 4, stab neutrophils - 8, segmented neutrophils - 56,
lymphocytes-26, monocytes - 4. How can we interpret these changes in the white blood cells?
a) Neutrophilia with a degenerative left shift
b) Lymphocytosis
c) Neutrophilia with a regenerative left shift
d) Neutrophilic leukocytosis with a right shift
e) Neutrophilia with a hyperregenerative left shift
A patient, who had suffered severe blood loss three days ago, underwent blood test. The following
data was obtained in leukogram: leukocytes -12∙ 109/1, basophils - 0, eosinophils – 3, myelocytes
– 0, juvenile – 3, stab neutrophils -12, segmented neutrophils – 62, lymphocytes – 16, monocytes
– 4. What change of leukocyte content occurred in this case?
A. Absolute lymphopenia
B. Neutrophilia with regenerative left-shift
C. Absolute monocytopenia
D. Neutrophilia with degenerative left-shift
E. Neutrophilia with right-shift
A 59-year-old woman has been hospialized in a surgical ward due to exacerbation of chronic
osteomyelitis of the left shin. Blood test: leukocytes -15, 0 • 109/1. Leukogram: myelocytes – 0%,
metamyelocytes - 8%, stab neutrophi-ls - 28%, segmented neutrophils - 32%, lymphocytes - 29%,
monocytes - 3%. Such blood count would be called:
A. Regenerative-degenerative left shift
B. Degenerative left shift
C. Hyperregenerative left shift
D. Right shift
E. Regenerative left shift
Leukemia
38. A 23 y.o. patient complains of weakness, temperature rise up to 38-400C. Objectively: liver
and spleen are enlarged. Hemogram: Hb- 100 g/l, erythrocytes - 2,9*1012/l, leukocytes - 4,4*109/l,
thrombocytes – 48*109/l, segmentonuclear neutrophils - 17%, lymphocytes - 15%, blast cells -
68%. All cytochemical reactions are negative. Make a hematological conclusion:
A. Undifferentiated leukosis
B. Chronic myeloleukosis
C. Acute myeloblastic leukosis
D. Acute lymphoblastic leukosis
E. Acute erythromyelosis
39. The total number of leukocytes in patient's blood is 90•109/1. Leukogram: eosinophils - 0%,
basophils - 0%, juvenile - 0%, stab neutrophils -2%, segmentonuclear cells - 20%, lymphoblasts -
1%, prolymphocytes -2%, lymphocytes - 70%, monocytes - 5%, Botkin-Gumprecht cells. Clinical
examination revealed enlarged cervical and submandibular lymph nodes. Such clinical
presentations are typical for the following pathology:
A. Chronic lympholeukosis
B. Chronic myeloleukosis
C. Acute lympholeukosis
D. Lymphogranulomatosis
E. Infectious mononucleosis
40. A patient suffering from chronic myeloleukemia has got the following symptoms of anemia:
decreased number of erythrocytes and low haemoglobin concentration, oxyphilic and
polychromatophilic normocytes, microcytes. What is the leading pathogenetic mechanism of
anemia development?
A. Substitution of haemoblast
B. Reduced synthesis of erythropoietin
C. Chronic haemorrhage
D. Intravascular hemolysis of erythrocytes
E. Deficiency of vitamin B12
41. A 39-year-old patient underwent hematologic tests. The following results were
obtained: RBC- 2,8 • 1012/L, Hb- 80 g/L, color index - 0,85, reticulocytes - 0,1%, platelets - 160
• 109/L, WBC - 60 • 109/L. Basophils - 2, eosinophils - 8, promyelocytes - 5, myelocytes - 5,
immature neutrophi¬ls - 16, stab neutrophils - 20, segmented neutrophils - 34, lymphocytes - 5,
monocytes- 5. What form of blood pathology are these results indicative of?
a) Chronic myeloid leukemia
b) Undifferentiated leukemia
c) Hemolytic anemia
d) Acute myeloid leukemia
e) Hypoplastic anemia
Disturbances in Hemostasis. Changes in the physicochemical properties of blood

42. 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
43. A patient is diagnosed with hereditary coagulopathy that is characterized by factor VIII
deficiency. Specify the phase of blood clotting during which coagulation will be disrupted in the
given case:
A. Thromboplastin formation
B. Thrombin formation
C. Fibrin formation
D. Clot retraction
E. –
44. A 3-year-old boy with pronounced hemorrhagic syndrome doesn't have antihemophilic
globulin A (factor VIII) in the blood plasma. Hemostasis has been impaired at the following stage:
A. Internal mechanism of prothrombinase activation
B. External mechanism of prothrombinase activation
C. Conversion of prothrombin to thrombin
D. Conversion of fibrinogen to fibrin
E. Blood clot retraction
45. A 12-year-old patient has been admitted 3 a hospital for hemarthrosis of the knee Dint. From
early childhood he suffers from frequent bleedings. Diagnose the boy’s disease:
A. Hemophilia
B. B12 (folic acid)-deficiency anemia
C. Hemolytic anemia
D. Thrombocytopenic purpura
E. Hemorrhagic vasculitis
46. Tooth extraction in a patient with chronic persistent hepatitis was complicated by a prolonged
bleeding. What is the cause of hemorrhagic syndrome?
A. Decreased production of thrombin
B. Decreased production of fibrin
C. Increased synthesis of fibrinogen
D. Increased fibrinolysis
E. Increased production of thromboplastin
47. A patient underwent a surgery for excision of a cyst on pancreas. After this he developed
haemorrhagic syndrome with apparent disorder of blood coagulation. Development of this
complication can be explained by:
A. Activation of fibrinolytic system
B. Insufficient fibrin production
C. Reduced number of thrombocytes
D. Activation of anticoagulation system
E. Activation of Christmas factor
48. After a tourniquet application a patient was found to have petechial haemorrhages. The reason
for it is the dysfunction of the following cells:
A. Platelets
B. Neutrophils
C. Monocytes
D. Eosinophils
E. Lymphocytes
49. A 43-year-old patient has thrombopenia, reduction of fibrinogen, products of degradation of

fibrin presented in the blood, petechial haemorrhage along with septic shock. What is the most
likely cause of the changes?
A. DIC-syndrome
B. Autoimmune thrombocytopenia
C. Haemorrhagic diathesis
D. Disorder of thrombocytes production
E. Exogenous intoxication
50. A patient was ill with burn disease that was complicated by DIC syndrome. What stage of DIC
syndrome can be suspected if it is known that the patient's blood coagulates in less than 3 minutes?
A. Hypercoagulation
B. Transition phase
C. Hypocoagulation
D. Fibrinolysis
E. Terminal
51. A patient, who had been working hard under conditions of elevated temperature of the
environment, has now a changed quantity of blood plasma proteins. What phenomenon is the case?
A. Relative hyperproteinemia
B. Absolute hyperproteinemia
C. Absolute hypoproteinemia
D. Dysproteinemia
E. Paraproteinemia
52. A patient has petechial hemorrhages on the gums, hard and soft palate, buccal mucosa. This is
caused by the dysfunction of the following blood corpuscles:
A. Monocytes
B. Eosinophils
C. Platelets
D. Lymphocytes
E. Erythrocytes
53. Due to trauma the patient has lost 25% of circulating blood volume. Name the emergency
compensatory mechanism against blood loss:
A. Interstitial fluid inflow to the vessels
B. Restoration of erythrocyte number
C. Restoration of blood protein composition
D. Increase of reticulocyte number
E. Erythropoiesis activation
54. A 54-year-old man complains of general weakness, frequent colds, and bruises constantly
appearing on his body. Blood test: erythrocytes - 2.5 · 1012/L; Hb- 80 g/L; color index - 0.9;
reticulocytes - absent; platelets - 50 · 109/L; leukocytes - 58 · 109/L; leukogram: basocytes - 5%,
eosinophils - 15%, myeloblasts - 6%, myelocytes - 10%, juvenile - 18%, stab neutrophils - 26%,
segmented neutrophils - 10%, lymphocytes - 8%, monocytes - 2%, ESR - 40mm/hour. What
hematologic conclusion can be made?
A. Chronic myelogenous leukemia
B. Myeloblastic leukemia
C. Chronic lymphocytlc leukemia
D. Basophilic eosinophilic leukocytosis
E. Leukemoid response
55. 24 hours after an appendectomy the patient’s blood test shows neutrophilic leukocytosis with
a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in
the patient’s peripheral blood?
A. Intensification of 55eucopoiesis
B. Immunity activation
C. Decreased leukocyte disintegration
D. Deceleration of leukocyte migration to the tissues
E. Leukocyte redistribution
56. A patient has been suffering from bronchial asthma for 15 years. What changes in the patient`s
leukogram can be expected in this case?
A. Leukopenia
B. Leukocytosis
C. Left shift
D. Eosinophilia
E. Basophilia
57. Hematologic study shows the following pattern: erythrocytes - 2,8 * 1012/L, Hb - 80 g/L, color
index - 0.85, reticulocytes - 0.1%, platelets - 160 thousand per microliter, leukocytes - 60 * 109/L.
Basocytes - 2%, eosinophils - 8%, promyelocytes - 5%, myelocytes - 5%, juvenile - 16%, stab
neutrophils - 20%, segmented neutrophils - 34%, lymphocytes - 5%, monocytes - 5%. This clinical
presentation indicated the following blood pathology:
A. Undifferentiated leukemia
B. Acute myeloleukemia
C. Hemolytic anemia
D. Hypoplastic anemia
E. Chronic myeloleukemia
58. 24 hours after an appendectomy the patient's blood test shows neutrophilic leukocytosis with
a regenerative shift. What is the most likely mechanism of absolute leukocytosis development in
the patient's peripheral blood?
A. Leukocyte redistribution
B. Decreased leukocyte disintegration
C. Immunity activation
D. Intensification of leukopoiesis
E. Deceleration of leukocytes migration to the tissues
59. A patient was brought to the hospital with a lacerated wound of the maxillofacial area. Profuse
bleeding from the wound could not stopped for a long time. What disturbance of total blood
volume will be observed within the first hour after the blood loss occurred?
A. Hypervolemia
B. Oligocythemic hypovolemia
C. No disturbances in blood volume
D. Polycythemic hypovolemia
E. Normocythemic hypovolemia
1. ECG of a 44-year-old patient shows signs of hypertrophy of both ventricles and the right atrium.
The patient was diagnosed with the tricuspid valve insufficiency. What pathogenetic variant of
cardiac dysfunction is usually observed in case of such insufficiency?
A. Heart overload by volume
B. Heart overload by resistance
C. Primary myocardial insufficiency
D. Coronary insufficiency
E. Cardiac tamponade
2. In course of a preventive examination of a miner a doctor revealed changes of cardiovascular

fitness, which was indicative of cardiac insufficiency at the compensation stage. What is the main
proof of cardiac compensation?
A. Myocardium hypertrophy
B. Tachycardia
C. Rise of arterial pressure
D. Dyspnea
E. Cyanosis
3. Dystrophic changes of the heart muscle are accompanied with cardiac cavity enlargement,
decrease of the strength of heart contraction, increased amount of blood, which remains in the
heart during systolic phase, overfilled veins. For what state of heart is it characteristic?
A. Myogenic dilatation
B. Tonogenic dilatation
C. Emergency stage of hyperfunction and hypertrophy
D. Cardiosclerosis
E. Tamponade of the heart
4. A patient has a history of chronic heart failure. Which of the following hemodynamic parameters
is a major symptom of cardiac decompensation development?
A. Tachycardia development
B. Tonogenic dilatation
C. Decreased stroke volume
D. Increased peripheral vascular resistance
E. Increased central venous pressure
5. An animal with aortic valve insufficiency got hypertrophy of its left heart ventricle. Some of its
parts have local contractures. What substance accumulated in the myocardiocytes caused these
contractures?
A. Calcium
B. Potassium
C. Lactic acid
D. Carbon dioxide
E. Sodium
6. A 49-year-old mae has mitral stenosis. What is the leading mechanism of heart failure
in this case?
a) Pressure overload
b) Fluid overload
c) Myocardial injury
d) Volume overload
e) Myocardial tension
7. ECG of a 46-year-old patient shows an increase in the QRS duration. This might be
caused by:
a) Increased ventricular activation time
b) Increased atrial excitability
c) Increased atrial and ventricular excitability
d) Increased atrial activation time
e) Conduction disturbances in the AV node
8. An athlete (long-distance runner) during a contest developed a case of acute cardiac

insufficiency. This pathology resulted from:
A. Cardiac pressure overload
B. Disrupted coronary circulation
C. Direct damage to myocardium
D. Pericardium pathology
E. Cardiac volume overload
9. Processes of repolarisation are disturbed in ventricular myocardium in examined person. It will
cause amplitude abnormalities of configuration and duration of the wave:
A. Т
B. Q
C. R
D. S
E. P
10. Person has stable HR, not more than 40 bpm. What is the pacemaker of the heart rhythm in
this person?
A. Atrioventricular node
B. Sinoatrial node
C. His’ bundle
D. Branches of His’ bundle
E. Purkinye’ fibers
11. A patient has a first-degree atrioventricular block accompanied by the prolongation of P-Q
interval up to 0,25 s. Under such conditions the following myocardial function will be disturbed:
A. Conduction
B. Excitability
C. –
D. Automatism
E. Contractibility
12. A patient has extrasystole. ECG shows no P wave, QRS complex is deformed, there is a full
compensatory pause. What extrasystoles are these?
A. Ventricular
B. Atrial
C. Atrioventricular
D. Sinus
E. –
13. A 45-year-old patient was admitted to the cardiological department. ECG data: negative P
wave overlaps QRS complex, diastolic interval is prolonged after extrasystole. What type of
extrasystole is it?
A. Atrioventricular
B. Sinus
C. Atrial
D. Ventricular
E. Bundle-branch
14. A 67-year-old patient complains of periodic heart ache, dyspnea during light physical
activities. ECG reveals extraordinary contractions of heart ventricles. Such arrhythmia is called:
A. Extrasystole
B. Bradycardia
C. Tachycardia
D. Flutter
E. Fibrillation
15. Analysis of the ECG revealed the missing of several PQRST cycles. The remaining waves and
complexes are not changed. Specify the type of arrhythmia:
A. Sinoatrial block
B. Atrial fibrillation
C. Atrioventricular block
D. Intra-atrial block
E. Atrial premature beat
16. In a 45-year-old patient on ECG it was revealed: sinus rhythm, the number of auricular
complexes exceeds number of ventricular complexes; progressing extension of the P-Q interval
from complex to complex; fallout of some ventricular complexes; Р waves and QRST complexes
are without changes. Name the type of heart rhythm dysfunction.
A. Atrioventricular block of the II degree
B. Synoauricular block
C. Atrioventricular blockade of the I degree
D. Intraatrial block
E. Complete atrioventricular block
17. A 49 y.o. woman consulted a doctor about heightened fatigue and dyspnea during physical
activity. ECG: heart rate is 50/min, PQ is extended, QRS is unchanged, P wave quanity exceeds
quantity of QRS complexes. What type of arrhythmia does the patient have?
A. Atrioventricular block
B. Extrasystole
C. Sinus bradycardia
D. Ciliary arrhythmia
E. Sinoatrial block
18. ECG of a patient shows such alterations: P-wave is normal, P-Q-interval is short, ventricular
QRST complex is wide, R-wave is double-peak or two-phase. What form of arrhythmia is it?
A. WPW syndrome (Wolff-Parkinson-White)
B. Frederick’s syndrome (atrial flutter)
C. Atrioventricular block
D. Ventricular fibrillation
E. Ciliary arrhythmia
19. A patient who suffers from severe disorder of water-salt metabolism experienced cardiac arrest
in diastole. What is the most probable mechanism of cardiac arrest in diastole?
A. Hyperkaliemia
B. Hypernatremia
C. Organism dehydratation
D. Hypokaliemia
E. Hyponatremia
20. A patient complains of palpitations after stress. Pulse is 104Imin., P-Q=0,12 11 seconds,
there are no changes in QRS st complex. What type of arrhythmia does the d. patient have
A. Ciliary arrhythmia
B. Sinus tachycardia
D. Extrasystole
E. Sinus arrhythmia
Coronarogenic injury of the myocardium. Coronary vessels insufficiency. Ischemic heart

disease. Myocardial infarction. Cardiogenic shock.
21. After a serious psycho-emotional stress a 45-year-old patient suddenly felt constricting heart
pain irradiating to the left arm, neck and left scapula. His face turned pale, the cold sweat stood
out on it. The pain attack was stopped with nitroglycerine. What process has developed in this
patient?
A. Stenocardia
B. Myocardial infarction
C. Stroke
D. Psychogenic shock
E. Stomach ulcer perforation
22. After a serious psychoemotional stress a 48 year old patient suddenly developed acute heart
ache irradiating to the left arm. Nitroglycerine relieved pain after 10 minutes. What is the leading
pathogenetic mechanism of this process development?
A. Spasm of coronary arteries
B. Dilatation of peripheral vessels
C. Obstruction of coronary vessels
D. Compression of coronary vessels
E. Increase in myocardial oxygen consumption
23. After a psychoemotional stress a 48 year old patient had a sudden attack of acute heart pain
with irradiation to the left hand. Nitroglycerine suppressed pain in 10 minutes. What pathogenetic
mechanism is principal for the pain development?
A. Spasm of coronary vessels
B. Dilatation of peripheral vessels
C. Coronary vessel occlusion
D. Embarrassment of coronary vessels
E. Increased need of myocardium in oxygen
24. A patient is 59 years old and works as director of a private enterprise. After the inspection by
tax authorities he developed intense burning retrosternal pain radiating to the left arm. After 15
minutes the patient returned to normal. What is the leading mechanism for the development of
stenocardia in this patient?
A. Increased level of blood catecholamines
B. Functional overload of heart
C. Coronary thrombosis
D. Coronary atherosclerosis
E. Intravascular aggregation of blood corpuscles
25. A patient suffering from stenocardia was taking nitroglycerine which caused restoration of
blood supply of myocardium and relieved pain in the cardiac area. What intracellular mechanism
provides restoration of energy supply of insulted cells?
A. Intensification of ATP resynthesis
B. Reduction of ATP resynthesis
C. Increased permeability of membranes
D. Intensification of oxygen transporting into the cell
E. Intensification of RNA generation
26. During fighting a man had a cardiac arrest as a result of a hard blow to the upper region of
anterior abdominal wall. Which of the described mechanisms might have provoked the cardiac
arrest?
A. Parasympathetic unconditioned reflexes
B. Sympathetic unconditioned reflexes
C. Peripheric reflexes
D. Sympathetic conditioned reflexes
E. Parasympathetic conditioned reflexes
27. A 59 year old patient is a plant manager. After the tax inspection of his plant he felt intense
pain behind his breastbone irradiating to his left arm. 15 minutes later his condition came to
normal. Which of the possible mechanisms of stenocardia development is the leading in this case?
A. High catecholamine concentration in blood
B. Coronary atherosclerosis
C. Intravascular aggregation of blood corpuscles
D. Coronary thrombosis
E. Functional heart overload
28. The patient with acute myocardial infarction was given intravenously different solutions during
8 hours with medical dropper 1500 ml and oxygen intranasally. He died because of pulmonary
edema. What caused the pulmonary edema?
A. Volume overload of the left ventricular
B. Decreased oncotic pressure due to hemodilution
C. Allergic reaction
D. Neurogenic reaction
E. Inhalation of the oxygen
29. A patient with extensive myocardial infarction has developed heart failure. What pathogenetic
mechanism contributed to the development of heart failure in the patient?
A. Reduction in the mass of functioning myocardiocytes
B. Pressure overload
C. Acute cardiac tamponade
D. Myocardial reperfusion injury
E. Volume overload
30. Since a patient has had myocardial infarction, atria and. ventricles contract dependently from
each , other with a sequence of 60-70 and 35-40 per minute. Specify the type of heart block in this
case:
A. Complete atrioventricular
B. Sino-atrial
C. Intraventricular
D. Intra-atrial
E. Partial atrioventricular
31. A 47 year old man with myocardium infarction was admitted to the cardiological department.
What changes of cellular composition of peripheral blood are induced by necrotic changes in the
myocardium?
A. Neutrophilic leukocytosis
B. Monocytosis
C. Eosinophilic leukocytosis
D. Thrombocytopenia
E. Lymphopenia
32. Transmural myocardial infarction in the patient was complicated with progressive acute left
ventricle insufficiency. What is the most typical for this state?
A. Edema of the lungs
B. Edema of the extremities
C. Cyanosis
D. Ascites
E. Arterial hypertension
33. A 49-year-old male patient with myocardial infarction has been admitted to the
cardiology department. What changes in the peripheral blood cells are induced by the
necrotic changes in the myocardium?
a) Neutrophilic leukocytosis
b ) Lymphopenia
c) Eosinophilia
d) Thrombocytopenia
e) Monocytosis
Pathophysiology of blood vessels. Arterial hypertension and hypotension.

34. A 43-year-old-patient has arterial hypertension caused by an increase in cardiac output and
general peripheral resistance. Specify the variant of hemodynamic development of arterial
hypertension in the given case:
A. Eukinetic
B. Hyperkinetic
C. Hypokinetic
D. –
E. Combined
35. Prophylactic medical examination of a 36-year-old driver revealed that his AP was 150/90 mm
Hg. At the end of working day he usually hears ear noise, feels slight indisposition that passes after
some rest. He was diagnosed with essential hypertension. What is the leading pathogenetic
mechanism in this case?
A. Neurogenic
B. Nephric
C. Humoral
D. Endocrinal
E. Reflexogenic
36. Arterial pressure of a surgeon who performed a long operation rised up to 140/110 mm Hg.
What changes of humoral regulation could have caused the rise of arterial pressure in this case?
A. Activation of sympathoadrenal system
B. Activation of formation and excretion of aldosterone
C. Activation of renin angiotensive system
D. Activation of kallikrein kinin system
E. Inhibition of sympathoadrenal system
37. A patient has the following diagnosis: renal hypertension. What is the initial pathogenetic
factor of arterial hypertension development in this case?
A. Renal ischemia
B. Hypernatremia
C. Hyperaldosteronism
D. Intensified renin synthesis
E. Intensified angiotensin synthesis
38. A patient with constant headaches, pain the occipital region, tinnitus, dizziness has in admitted
to the cardiology department, objectively: AP - 180/110 mm Hg, heart rate 5/min.
Radiographically, there is a stenosis one of the renal arteries. Hypertensive condition in this patient
has been caused by in activation of the following system:
A. Renin-angiotensin
B. Sympathoadrenal
C. Kinin
D. Immune
E. Hemostatic
39. Arterial hypertension is caused by the stenosis of the renal arteries in the patient. Activation of
what system is the main link in the pathogenesis of this form of hypertension?
A. Renin-angiotensin
B. Sympathoadrenal
C. Parasympathetic
D. Kallikrein-kinin
E. Hypothalamic-pituitary
40. A month after surgical constriction of rabbit’s renal artery the considerable increase of
systematic arterial pressure was observed. What of the following regulation mechanisms caused
the animal’s pressure change?
A. Angiotensin-II
B. Serotonin
C. Noradrenaline
D. Adrenaline
E. Vasopressin
41. A patient ill with essential arterial hypertension had a hypertensic crisis that resulted in an
attack of cardiac asthma. What is the leading mechanism of cardiac insufficiency in this case?
A. Heart overload caused by high pressure
B. Heart overload caused by increased blood volume
C. Absolute coronary insufficiency
D. Myocardium damage
E. Blood supply disturbance
42. A 50 year old patient suffers from essential hypertension. After a physical stress he experienced
muscle weakness, breathlessness, cyanosis of lips, skin and face. Respiration was accompanied by
distinctly heard bubbling rales. What mechanism underlies the development of this syndrome?
A. Acute left-ventricular failure
B. Chronic right-ventricular failure
C. Chronic left-ventricular failure
D. Collapse
E. Cardiac tamponade
43. An 18-year-old patient complains of general weakness, fatigue, low spirits. The patient is of
the asthenic constitution type. Ps - 68/min., AP - 90/60 mm Hg. She has been found to have
primary neurocirculatory hypotension. What is the leading factor of the arterial pressure drop in
this patient?
A. Decreased tonus of resistive vessels
B. Decreased minute blood volume
C. Hypovolemia
D. Deposition of blood in the veins of the systemic circulation
E. Decreased cardiac output
44. In crisis period a 14 year old child ill with diphtheria has AP- 70/50 mm Hg accompanied by
abrupt fall in temperature and tachycardia. What form of vascular tone disturbance is it?
A. Acute hypotension
B. Chronic hypotension
C. Vegetovascular dystonia
D. Essential arterial hypotension
E. –
45. A patient has insufficient blood supply to the kidneys, which caused the development of pressor
effect due to the constriction of arterial resistance vessels. This is the result of the vessels being
greately affected by the following substance:
A. Catecholamines
B. Norepinephrine
C. Renin
D. Angiotensin II
E. Angiotensinogen
Vascular insufficiency. Atherosclerosis.

46. Rabbits lived on food with addition of cholesterol. Five months later the atherosclerotic aorta
changes were revealed. Name the main cause of atherogenesis in this case:
A. Exogenous hypercholesterolemia
B. Overeating
C. Hypodynamia
D. Endogenous hypercholesterolemia
E. –
47. A 70-year-old patient suffers from atherosclerosis complicated by the lower limb thrombosis
that has caused gangrene on his left toes. What is the most likely cause of the thrombosis origin?
A. Thrombocyte adhesion
B. Prothrombinase activation
C. Transformation of prothrombin into thrombin
D. Transformation of fibrinogen into fibrin
E. Impaired heparin synthesis
48. A 67-year-old patient has atherosclerosis of cardiac and cerebral vessels. Examination revealed
hyperlipidemia. What class of blood plasma lipoproteids is most important in atherosclerosis
pathogenesis?
A. Low-density lipoproteids
B. High-density lipoproteids
C. a-lipoproteids
D. -
E. Chylomicrons
Pathophysiology of external respiration. Respiratory insufficiency.

49. An unconscious young man with signs of morphine poisoning entered admission office. His
respiration is shallow and infrequent which is caused by inhibition of respiratory centre. What type
of respiratory failure is it?
A. Ventilative dysregulatory
B. Ventilative obstructive
C. Ventilative restrictive
D. Perfusive
E. Diffusive
50. A patient with bronchial asthma has developed acute respiratory failure. What kind of
respiratory failure occurs in this case?
A. Obstructive disturbance of alveolar ventilation
B. Restrictive ventilatory defect
C. Perfusion
D. Diffusion
E. Dysregulation of alveolar ventilation
51. A 12 y.o. boy who suffers from bronchial asthma has an acute attack of asthma: evident
expiratory dyspnea, skin pallor. What type of alveolar ventilation disturbance is it?
A. Obstructive
B. Restrictive
C. Throracodiaphragmatic
D. Central
E. Neuromuscular
52. A patient has a history of chronic obstructive bronchitis. Blood gas analysis revealed the
development of hypoxemia and hypercapnia on the background of dyspnea, tachycardia and
cyanosis. What disorder of external respiration is observed in the patient?
A. Hypoventilation
B. Hyperperfusion
C. Hyperventilation
D. Hyperdiffusion
E. Hypoperfusion
53. A patient with marked pneumofibrosis that developed after infiltrating pulmonary tuberculosis
has been diagnosed with respiratory failure. What is its pathogenetic type?
A. Restrictive
B. Dysregulatory
C. Obstructive
D. Reflex
E. Apneustic
54. A patient with evident pneumosclerosis that developed after infiltrative pulmonary tuberculosis
presents with respiratory failure. What is its pathogenetic type?
A. Restrictive
B. Apneustic
C. Obstructive
D. Reflectory
E. Dysregulative
55. A 50-year-old male patient suffers from chronic bronchitis, complains about dyspnea during
physical activity, sustained cough with sputum. After examination he was diagnosed with
pulmonary emphysema. This complication is caused by:
A. Decrease in lung elasticity
B. Decrease in lung compliance
C. Decrease in lung perfusion
D. Decrease in alveolar ventilation
E. Ventilation-perfusion disbalance
56. Examination of a miner revealed pulmonary fibrosis accompanied by disturbance of alveolar

ventilation. What is the main mechanism of this disturbance?
A. Limitation of respiratory surface of lungs
B. Constriction of superior respiratory tracts
C. Disturbance of neural respiration control
D. Limitation of breast mobility
E. Bronchi spasm
57. A patient staying in the pulmonological department was diagnosed with pulmonary
emphysema accompanied by reduced elasticity of pulmonary tissue. What type of respiration is
observed?
A. Expiratory dyspnea
B. Inspiratory dyspnea
C. Superficial respiration
D. Infrequent respiration
E. Periodic respiration
58. A 23-year-old patient has been admitted to a hospital with a craniocerebral injury. The patient
is in a grave condition. Respiration is characterized by prolonged convulsive inspiration followed
by a short expiration. What kind of respiration is it typical for?
A. Apneustic
B. Gasping breath
C. Kussmaul’s
D. Cheyne-Stokes
E. Biot’s
59. A 23 year patient was admitted to the hospital in grave condition with craniocerebral trauma.
His respiration is characterized by a spasmodic long inspiration interrupted by a short expiration.
What respiration type is it typical for?
A. Apneustic
B. Gasping
C. Kussmaul’s respiration
D. Cheyne-Stokes respiration
E. Biot’s respiration
60. A 62-year-old patient was admitted to the neurological department due to cerebral
haemorrhage. Condition is grave. There is observed progression of deepness and frequency of
breathe that turnes into reduction to apnoea, and the cycle repeates. What respiration type has
developed in the patient?
A. Cheyne-Stockes respiration
B. Kussmaul’s respiration
C. Biot’s respiration
D. Gasping respiration
E. Apneustic respiration
61. A 62-year-old patient with cerebral haemorrhage was admitted to the neurological department
in grave condition. Objectively: increase of respiration depth and rate with its following reduction
to apnoea, thereafter respiration cycle restores. What respiration type is it?
A. Cheyne-Stokes
B. Biot’s
C. Gasping
D. Apneustic
E. Kussmaul’s
62. A patient with a craniocerebral injury presents with respiration characterized by progressively
deeper respiratory movements followed by a gradual decrease that results in a temporary stop in
breathing. What pattern of abnormal respiration are these features typical for?
A. Cheyne-Stokes
B. Biot’s
C. Kussmaul’s
D. Gasping
E. Apneustic
63. While having the dinner the child choked and aspirated the food. Meavy cough has started,
skin and mucosa are cyanotic, rapid pulse, rear breathing, expiration is prolonged. What disorder
of the external breathing developed in the child?
A. Stage of expiratory dyspnea on asphyxia
B. Stage of inspiratory dyspnea on asphyxia
C. Stenotic breathing
D. Alternating breathing
E. Biot's breathing
64. A 42-year-old patient with tetanus developed an acute respiratory failure. What type
of respiratory failure occurs in this case?
a) Disregulatory impairment of alveolar ventilation
b) Diffusion impairment
c) Obstructive impairment of alveolar ventilation
d) Restrictive impairment of alveolar ventilation
e) Perfusion impairment
65. Sharp decrease of lungs surfactant activity has been detected in a patient. It will result in the
following:
A. Alveoli will become prone to deflation
B. Hyperoxemia
C. Pulmonary ventilation increases
D. Airways resistance decreases
E. Respiratory muscles work decreases
66. A 30-year-old man has sustained an injury to his thorax in a traffic incident, which caused
disruption of his external respiration. What type of ventilatory difficulty can be observed in the
given case ?
A. Restrictive extrapulmonary ventilatory impairment
B. Obstructive ventilatory impairment
C. Impair ventilation regulation dysfunction
D. Restrictive pulmonary ventilatory impairment
E. Cardiovascular collapse
67. A 30-year-old man complains of suffocation, heaviness, in the chest on the right, general
weakness. Body temperature is 38,9o C. Objectively the right side of the chest lags behind the
left side during respiration. Pleurocentesis yielded exudate. What is the leading factor of
exudation in the patient?
A. Increased blood pressure
B. Increased permeability of the vessel wall
C. Decreased resorption of pleural fluid
D. Erythrocyte aggregation
E. Hypoproteinemia
68. A 67-year-old was delivered to the man cardiology unit with complaints of periodical pain in
the heart, dyspnea after even insignificant physical exertion, cyanosis, and edemas. ECG revealed
additional contractions of the heart ventricles. Name this type of rhythm disturbance:
A. Flutter
В. Tachycardia
C. Extrasуstole
D. Fibrillation
E. Bradycardia
69. A patient, who has been suffering from bronchial asthma for a long time, developed acute
respiratory failure. What is the main mechanism of pathology development in this case?
A. Obstructive disorders of pulmonary ventilation
B. Pulmonary blood supply disturbance
C. Pulmonary enzyme system disturbance
D. Decreased elasticity of the pulmonary tissue
E. Restrictive disorders of pulmonary ventilation
70. A women who has been suffering from marked hypertension for 15 years, has lately
developed dyspnea, palpitations, slightly decreased systolic pressure, while diastolic pressure
remains the same. What is the main mechanism of heart failure development in this case ?
A. Cardiac overload due to increased vascular resistance
B. Damage to the myocardium
C. Disorder of impulse conduction in the myocardium
D. Dysreguletion of cardiac function
E. Cardiac overload due to increase blood volume
71. A 15-year-old teenager complains of lack of air, general weakness, palpitations. Heart rate is
130 mm, BP is 100\60 mm Hg. ECG: QRS complex has normal shape and duration. The number
of P waves and ventricular complexes is equal, T wave merges with P wave. What type of
cardiac arrhythmia is observed in the teenager?
A. Atrial fibrillation
B. Sinus tachycardia
C. Sinus extrasystole
D. Paroxysmal atrial tachycardia
E. Atrial thrill
72. A 59-year-old man, a business manager, developed intense burning retrosternal pain that
irradiates to the left arm. The pain occurred in the evening after the tax audit. 15 minutes later the
patient’s condition normalized. What mechanism of angina pectoris development is leading in this
patient?
A. Increased level of blood catecholamines
B. Coronary artery thrombosis
C. Intravascular aggregation of blood cells
D. Coronary atherosclerosis
E. Functional cardiac overload
73. A 17-year-old girl suffers from periodical palpitations that last several minutes. Her heart rate
is 200/min, rhythmic. What heart rhythm disorder developed in this patient?
A. Paroxysmal tachycardia
B. Atrioventricular block
D. Extrasystole
E. Sinus tachycardia
74. ECG of the patient shows increased duration of the QRS complex. What is the most likely
cause?
A. Disturbed conduction in the atrioventricular node
B. Increased atrial and ventricular excitability
C. Increased atrial excitability
D. Increased period of ventricular excitation
E. Increased period of atrial excitation
75. After a psychic trauma a woman developed periodical increases in her blood pressure
accompanied by headache, palpitations, and general weakness. What mechanism of hypertension
development does this woman have?
A. Increased arteriolar tone
B. Decreased cardiac output
C. Increased circulating blood volume
D. Tachycardia
E. Venoconstriction
76. A 48-year-old man is unconscious. He has a history of several syncopal episodes with
convulsions. ECG shows deformed QRS complexes unconnected with P waves, atrial contractions
are approximately 70/min., ventricular contractions – 25-30/min. Name the type of arrhythmia in
this case:
A. Complete atrioventricular block
B. First-degree atrioventricular block
C. Intraventricular block
D. Second-degree atrioventricular block
E. Intraatrial block
77. A 14-year-old adolescent has diphtheria. During the peak of the disease against the background
of acute drop in body temperature and tachycardia the blood pressure is 70/50 mm Hg. What type
of vascular tone disturbance is it?
A. Acute hypotension
B. Somatoform autonomic dysfunction
C. –
D. Essential hypotension
E. Chronic hypotension
78. A patient with asphyxia after a brief respiratory arrest developed single infrequent respirations
with passive expiration, after which he stopped breathing completely. What type of respiration
was observed in this case?
A. Gasping respiration
B. Cheyne-Stokes respiration
C. Kussmaul respiration
D. Apneustic respiration
E. Biot respiration
79. A patient on the 2nd day after a cardiac infarction presents with acute decrease of systolic
blood pressure down to 66 mm Hg with tachycardia 140/min., dyspnea, loss of consciousness.
What mechanism is essential in the pathogenesis of shock development in this case?
A. Increased myocardial excitability caused by production of necrotic disintegration
B. Decreased circulating blood volume
C. Development of anaphylactic reaction to myocardial proteins
D. Development of paroxysmal tachycardia
E. Decreased cardiac output
1. A 42-year-old patient complains of pain in the epigastral area, vomiting; vomit masses
have the colour of “coffee-grounds”, the patient has also melena. Anamnesis records gastric ulcer.
Blood formula: erythrocytes – 2,8×1012/l, leukocytes – 8×109/l, Hb – 90 g/l. What complication is
it?
A. Haemorrhage
B. Pyloric stenosis
C. Penetration
D. Canceration
E. Perforation
2. During an acute experiment some of diluted solution of hydrochloric acid was injected
into the duodenal cavity of an experimental animal. This will result in hypersecretion of the
following hormone:
A. Secretin
B. Motilin
C. Histamine
D. Neurotensin
E. Gastrin
3. A 57-year-old patient was admitted to the gastroenterological department with suspicion

on Zollinger-Ellison syndrome because of rapid increase of gastrin level in the blood serum. What
disorder of the secretory function of the stomach is the most likely?
A. Hyperacid hypersecretion
B. Hyperacid hyposecretion
C. Achylia
D. Hypoacid hyposecretion
E. Hypoacid hypersecretion
4. Roentgenologically confirmed obstruction of common bile duct resulted in preventing bile

from inflowing to the duodenum. What process is likely to be disturbed?
A. Fat emulgation
B. Hydrochloric acid secretion in stomach
C. Carbohydrate hydrolysis
D. Protein absorption
E. Salivation inhibition
5. A 35-year-old man with peptic ulcer disease has undergone antrectomy. After the surgery
secretion of the following gastrointestinal hormone will be disrupted the most:
A. Gastrin
B. Cholecystokinin
C. Secretin
D. Neurotensin
E. Histamine
6. Hepatitis has led to the development of hepatic failure. Mechanism of edemata formation
is activated by the impairment of the following liver function:
A. Protein-synthetic
B. Barrier
C. Chologenetic
D. Antitoxic
E. Glycogen-synthetic
7. A tooth extraction in a patient with chronic persistent hepatitis was complicated with
prolonged hemorrhage. What is the reason for the haemorrhagic syndrome?
A. Decrease in thrombin production
B. Fibrinolysis intensification
C. Increase in thromboplastin production
D. Increase in fibrinogen synthesis
E. Decrease in fibrin production
8. As a result of dysfunction of protein synthesis in liver a patient with hepatic insufficiency

has disturbed synthesis of procoagulants, prothrombin, fibrinogen. Which of the listed syndromes
can be expected in this patient?
A. Haemorrhagic
B. Acholia syndrome
C. Portal haemorrhagic syndrome
D. Hepatolienal syndrome
E. Cholaemia syndrome
9. A patient who has been treated for viral hepatitis B developed symptoms of hepatic
insufficiency. What changes indicating disorder in protein metabolism are likely to be observed in
this case?
D. Absolute hyperglobulinemia
E. Protein rate in blood will stay unchanged
10. A patient being treated for viral hepatitis type B got symptoms of hepatic insufficiency.
What blood changes indicative of protein metabolism disorder will be observed in this case?
D. Proteinic blood composition is unchanged
E. Absolute hyperglobulinemia
11. A patient presents with icteritiousness of skin, scleras and mucous membranes. Blood
plasma the total bilirubin is increased, stercobilin is increased in feces, urobilin is increased in
urine. What type of jaundice is it?
A. Haemolytic
B. Gilbert’s disease
C. Parenchymatous
D. Obturational
E. Cholestatic
12. A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated),
high concentration of stercobilin in the stool and urine. The level of direct (conjugated) bilirubin
in the blood plasma is normal. What kind of jaundice can you think of?
A. Hemolytic
B. Parenchymal (hepatic)
C. Mechanical
D. Gilbert’s disease
E. Neonatal jaundice
13. Examination of a chemical plant worker who had had a poisoning revealed an increase
in total bilirubin concentration at the expense of indirect fraction. Feces and urine are characterized
by high stercobilin concentration. The level of direct bilirubin in blood plasma is normal. What
type of jaundice is the case?
A. Hemolytic
B. Mechanical
C. Parenchymatous
D. Obstructive
E. Hepatic
14. A 53-year-old male patient complains of acute pain in the right hypochondrium.
Objective examination revealed scleral icterus. Laboratory tests revealed increased ALT activity,
and stercobilin was not detected in the stool. What disease is characterized by these symptoms?
A. Cholelithiasis
B. Hemolytic jaundice
C. Hepatitis
D. Chronic colitis
E. Chronic gastritis
15. An infectious disease unit admitted a patient with signs of jaundice caused by hepatitis
virus. Select an indicator that is specific only for parenchymatous jaundice:
A. Increase in ALT and AST rate
B. Hyperbilirubinemia
C. Bilirubinuria
D. Cholaemia
E. Urobilinuria
16. A 48 y.o. patient was admitted to the hospital with complaints about weakness,
irritability, sleep disturbance. Objectively: skin and scleras are yellow. In blood: conjugated
bilirubin, cholalemia. Feces are acholic. Urine is of dark colour (bilirubin). What jaundice is it?
A. Mechanic
B. Hemolytic
C. Parenchymatous
D. Gilbert’s syndrome
E. Crigler-Najjar syndrome
17. Blood analysis of a patient with jaundice reveals conjugated bilirubinemia, increased
concentration of bile acids. There is no stercobilinogen in urine. What type of jaundice is it?
A. Obstructive jaundice
B. Hepatocellular jaundice
C. Parenchymatous jaundice
D. Hemolytic jaundice
E. Cythemolytic jaundice
18. A patient ill with jaundice has increased content of conjugated bilirubin and bile acids in
blood, no stercobilinogen in urine. What jaundice are these symptoms typical for?
A. Obstructive
B. Hepatic
C. Hepatocellular
D. Hemolytic
E. Cythemolytic
19. A patient with a pronounced icteritiousness of skin, sclera and mucous membranes has
urine of dark beer colour and colourless feces. Direct bilirubin in blood is elevated, urine contains
bilirubin. What type of jaundice is it?
A. Obstructive
B. Hemolytic
C. Parenchymatous
D. Excretory
E. Conjugation
20. A coprological survey revealed light-colored feces containing drops of neutral fat. The
most likely reason for this condition is the disorder of:
A. Bile inflow into the bowel
B. Pancreatic juice secretion
C. Intestinal juice secretion
D. Intestinal absorption
E. Gastric juice acidity
21. Upon toxic damage of hepatic cells resulting in disruption of liver function the patient
developed edemas. What changes of blood plasma are the main cause of edema development?
A. Increase of albumin conten
B. Decrease of fibrinogen conten
C. Decrease of albumin content
D. Decrease of globulin conten
E. Increase of globulin conten
22. As a result of dysfunction of protein synthesis in liver a patient with hepatic insufficiency has
disturbed synthesis of procoagulants, prothrombin, fibrinogen. Which of the listed syndromes can
be expected in this patient?
A. Haemorrhagic
B. Hepatolienal syndrome
C. Cholaemia syndrome
D. Portal haemorrhagic syndrome
E. Acholia syndrome
23.A 43-year-old patient has acute pancreatitis with concomitant disruption of common bile duct
patency. What condition can it result in?
A. Mechanical jaundice
B. Hepatic coma
C. Hemolytic jaundice
D. Portal hypertension
E. Hepatocellular jaundice
24. Specify the type of j jaundice, during which there is no direct bilirubin in blood, and urine
urobilinogen level is high:
A. Suprarenal
B. Mechanical
C. Hepatic
D. Subhepatic
E. –
25. For several days a 55-year-old woman has been suffering from pain attacks in the right upper
quadrant after eating fatty foods. Visually there is yellowness of sclera and skin. The patient has
acholic stool, beer - colored urine. What substance present in the patient’s urine causes its dark
color?
A. Bilirubin glucuronides
B. Unconjugated bilrubin
C. Ketone bodies
D. Stercobihn
E. Conjugated bilirubin
26. As a result of dysfunction of protein synthesis in liver a patient with hepatic insufficiency has
disturbed synthesis of procoagulants, prothrombin, fibrinogen. Which of the listed syndromes can
be expected in this patient?
A. Haemorrhagic
B. Hepatolienal syndrome
C. Cholaemia syndrome
D. Portal haemorrhagic syndrome
E. Acholia syndrome
27. A 43-year-old patient has acute pancreatitis with concomitant disruption of common bile duct
patency. What condition can it result in?
A. Mechanical jaundice
B. Hepatic coma
C. Hemolytic jaundice
D. Portal hypertension
E. Hepatocellular jaundice
28. A patient visited a dentist to extract a tooth. After the tooth had been extracted, bleeding from
the tooth socket continued for 15 minutes. Anamnesis states that the patient suffers from active
chronic hepatitis. What phenomenon can extend the time of hemorrhage ?
A. Thrombocytopenia
B. Decrease of fibrinogen content in blood
C. Decrease of albumine content in blood
D. Increased activity of anticoagulation system
E. Hypocalcemia
29. A 50-year-old man, who has been suffering from chronic hepatic failure for several years, has
developed ascites. What is the main mechanism of this disorder development ?
A. Decrease of albumin and globulin synthesis in liver
B. Neurotoxins appearing in blood
C. Increased pressure in portal vein system
D. Increased content of low-density and very low-density lipoproteins in blood
E. Increase of blood oncotic pressure
30. A man has a considerable decrease in diuresis as a result of 1,5 l blood loss. The primary
cause of such diuresis disorder is the hypersecretion of the following hormone:
A. Vasopressin
B. Parathormone
C. Corticotropin
D. Cortisol
E. Natriuretic
31. Shock and signs of acute renal failure (ARF) developed in the patient due to permanent injury.
What is the leading cause of development of ARF in the case?
A. Decreased arterial pressure
B. Urine excretion violation
C. Increased pressure in the nephron capsule
D. Increased pressure in the renal arteries
E. Decreased oncotic BP
32. A child has an acute renal failure. What biochemical factor found in saliva can confirm
this diagnosis?
A. Increase in urea concentration
B. Increase in concentration of higher fatty acids
C. Decrease in nucleic acid concentration
D. Increase in glucose concentration
E. Decrease in glucose concentration
33. On the 6th day of treatment a patient with acute renal insufficiency developed polyuria.
Diuresis intensification at the beginning of polyuria stage of acute renal insufficiency is caused
by:
A. Renewal of filtration in nephrons
B. Volume expansion of circulating blood
C. Growth of natriuretic factor
D. Reduction of aldosterone content in plasma
E. Reduction of vasopressin content in plasma
34. Diabetic nephropathy with uremia has developed in a patient with pancreatic diabetes.
The velocity of glomerular filtration is 9 ml/min. What mechanism of a decrease in glomerular
filtration velocity and chronic renal failure development is most likely in the case of this patient?
A. Reduction of active nephron mass
B. Decrease in systemic arterial pressure
C. Obstruction of nephron tubules with hyaline casts
D. Tissue acidosis
E. Arteriolar spasm
35. A patient with a history of chronic glomerulonephritis presents with azotemia, oliguria,
hypo- and isosthenuria, proteinuria. What is the leading factor in the pathogenesis of these
symptoms development under chronic renal failure?
A. Mass decrease of active nephrons
B. Intensification of glomerular filtration
C. Tubular hyposecretion
D. Disturbed permeability of glomerular membranes
E. Intensification of sodium reabsorption
36. Injection of an anaesthetic before the tooth extraction resulted in development of

anaphylactic shock accompanied by oliguria. What pathogenetic mechanism caused a decrease in
diuresis in this case?
A. Decrease in hydrostatic pressure in the renal corpuscle capillaries
B. Increase in hydrostatic pressure in the Bowman’s capsule
C. Damage of glomerular filter
D. Increase in vasopressin secretion
E. Increase in oncotic pressure of blood plasma
37. A driver who got a trauma in a road accident and is shocked has reduction of daily urinary
output down to 300 ml. What is the main pathogenetic factor of such diuresis change?
A. Drop of arterial pressure
B. Drop of oncotic blood pressure
C. Increased vascular permeability
D. Decreased number of functioning glomerules
E. Secondary hyperaldosteronism
38. A patient with massive burns developed acute renal insufficiency characterized by a
significant and rapid deceleration of glomerular filtration. What is the mechanism of its
development?
A. Reduction of renal blood flow
B. Damage of glomerular filter
C. Reduction of functioning nephron number
D. Rise of pressure of tubular fluid
E. Renal artery embolism
39. Due to the use of poor-quality measles vaccine for preventive vaccination, a 1-year-old
child developed an autoimmune renal injury. The urine was found to contain macromolecular
proteins. What process of urine formation was disturbed?
A. Filtration
B. Secretion and filtration
C. Reabsorption
D. Reabsorption and secretion
E. Secretion
40. Chronic glomerulonephritis was diagnosed in a 34-year-old patient 3 years ago. Edema
has developed in the last 6 months. What caused it?
A. Proteinuria
B. Hyperproduction of vasopressin
C. Disorder of albuminous kidneys function
D. Hyperosmolarity of plasma
E. Hyperaldosteronism
41. Two weeks after lacunar tonsillitis a 20-year-old man started complaining about general
weakness, lower eyelid edemata. After examination the patient was diagnosed with acute
glomerulonephritis. What are the most likely pathological changes in the urine formula?
A. Proteinuria
B. Cylindruria
C. Presence of fresh erythrocytes
D. Pyuria
E. Natriuria
42. A patient suffering from glomerulonephritis was found to have anasarca, AP of 185/105
mm Hg, anaemia, leukocytosis, hyperazotemia, hypoproteinemia. What factor indicates that
glomerulonephritis has been complicated by the nephrotic syndrome?
A. Hypoproteinemia
B. Anaemia
C. Arterial hypertension
D. Hyperazotemia
E. Leukocytosis
43. A patient with primary nephrotic syndrome has the following content of whole protein:
40 g/l. What factor caused hypoproteinemia?
A. Proteinuria
B. Transition of protein from vessels to tissues
C. Reduced protein synthesis in liver
D. Increased proteolysis
E. Disturbance of intestinal protein absorption
44. A patient with nephrotic syndrome has massive edemata of his face and limbs. What is
the leading pathogenetic mechanism of edemata development?
A. Drop of oncotic blood pressure
B. Increase of vascular permeability
C. Rise of hydrodynamic blood pressure
D. Lymphostasis
E. Increase of lymph outflow
45. A 30 year old woman has face edemata. Examination revealed proteinuria (5,87 g/l),
hypoproteinemia, dysproteinemia, hyperlipidemia. What condition is the set of these symptoms
typical for?
A. Nephrotic syndrome
B. Nephritic syndrome
C. Chronic pyelonephritis
D. Acute renal failure
E. Chronic renal failure
46. Violation of safety rules resulted in calomel intoxication. Two days later the daily
diuresis was 620 ml. A patient experienced headache, vomiting, convulsions, dyspnea, moist rales
in lungs. What pathology is it?
A. Acute renal insufficiency
B. Chronic renal insufficiency
C. Uraemic coma
D. Glomerulonephritis
E. Pyelonephritis
47. 14 days after quinsy a 15-year-old child presented with morning facial swelling, high
blood pressure, “meat slops” urine. Immunohistological study of a renal biopsy sample revealed
deposition of immune complexes on the basement membranes of the capillaries and in the
glomerular mesangium. What disease developed in the patient?
A. Acute glomerulonephritis
B. Necrotizing nephrosis
C. Acute interstitial nephritis
D. Acute pyelonephritis
E. Lipoid nephrosis
48. After the transfusion of the concentrated red blood cells the patient developed posttransfusion
shock. What is the leading mechanism of acute renal failure in this case?
A. Glomerular filtration disorder
B. Impairment of the renal incretory function
C. Tubular secretion disorder
D. Urinary excretion disorder
E. Tubular reabsorption disorder
49. A patient has oliguria caused by acute renal failure. What daily amount of urine corresponds
with this symptom?
A. 100-500 ml
B. 500-1000 ml
C. 1000-1500 ml
D. 1500-2000 ml
E. 50-100 ml
50. A patient has insufficient blood supply to the kidneys, which has caused the development of
pressor effect due to constriction of arterial resistance vessels. This condition results from the
vessels being strongly affected by the following substance:
A. Norepinephrine
B. Angiotensin II
C. Renin
D. Catecholamines
E. Angiotensinogen
51. Poisoning caused by mercury (II) chloride (corrosive sublimate) occurred in the result of
safety rules violation. In 2 days the patient’s diurnal diuresis became 620 ml. The patient developed
headache, vomiting, convulsions, dyspnea; moist crackles are observed in the lungs. Name this
pathology:
A. Acute renal failure
B. Chronic renal failure
C. Glomerulonephritis
D. Uremic coma
E. Pyelonephritis
52.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?
A. Arterial pressure drop
B. Disruption of urinary outflow
C. Increase of pressure in renal arteries
D. Increase of pressure in glomerular capsule
E. Decrease of oncotic blood pressure
53. After the transfusion of the concentrated red blood cells the patient developed posttransfusion
shock. What is the leading mechanism of acute renal failure in this case?
B. Impairment of the renal incretory function
C. Tubular secretion disorder
54. A patient complains of hydruria (7 liters per day) and polydipsia. Examination reveals
no disorders of carbohydrate metabolism. These abnormalities might be caused by the dysfunction
of the following endocrine gland:
A. Neurohypophysis
B. Adenohypophysis
C. Adrenal cortex
D. Islets of Langerhans (pancreatic islets)
E. Adrenal medulla
55. A woman after labor lost 20 kg of body weight, her hair and teeth fall out, she has muscle
atrophy (hypophysial cachexia). Synthesis of what hypophysis hormone is disturbed?
A. Somatotropic
B. Corticotrophic
C. Thyreotropic
D. Gonadotropic
E. Prolactin
56. Examination of a patient revealed enlargement of some body parts (jaw, nose, ears, feet,
hands), but body proportions were conserved. It might be caused by intensified secretion of the
following hormone:
A. Somatotropin
B. Somatostatin
C. Tetraiodothyronine
D. Triiodothyronine
E. Cortisol
57. Examination of a 42 year old patient revealed a tumour of adenohypophysis. Objectively:

the patient's weight is 117 kg, he has moon-like hyperemic face, red-blue striae of skin distension
on his belly. Osteoporosis and muscle dystrophy are present. AP is 210/140 mm Hg. What is the
most probable diagnosis?
A. Cushing’s disease
B. Cushing’s syndrome
C. Conn’s disease
D. Diabetes mellitus
58. A 38-year-old female patient complains of general weakness, cardiac pain, increased
appetite, no menstruation. Objectively: the height is 166 cm, weight 108 kg, the patient has moon-
shaped face, subcutaneous fat is deposited mainly in the upper body, torso and hips. There are also
blood-red streaks. Ps – 62/min, AP – 160/105 mm Hg. Which of the following diseases is the
described pattern of obesity most typical for?
A. Cushing pituitary basophilism
B. Alimentary obesity
C. Myxedema
D. Insulinoma
E. Babinski-Frohlich syndrome
59. A 46-year-old patient suffering from the diffuse toxic goiter underwent resection of the
thyroid gland. After the surgery the patient presents with appetite loss, dyspepsia, increased
neuromuscular excitement. The body weight remained unchanged. Body temperature is normal.
Which of the following has caused such a condition in this patient?
A. Reduced production of parathormone
B. Increased production of thyroxin
C. Increased production of calcitonin
D. Increased production of thyroliberin
E. Reduced production of thyroxin
60. A 5-month-old boy was hospitalized for tonic convulsions. He has a life-time history of this
disease. Examination revealed coarse hair, thinned and fragile nails, pale and dry skin. In blood:
calcium – 1,5 millimole/l, phosphor – 1,9 millimole/l. These changes are associated with:
A. Hypoparathyroidism
B. Hypoaldosteronism
C. Hyperparathyroidism
D. Hypothyroidism
E. Hyperaldosteronism
61. A child has abnormal formation of tooth enamel and dentin as a result of low
concentration of calcium ions in blood. Such abnormalities might be caused by deficiency of the
following hormone:
A. Parathormone
B. Thyroxin
C. Triiodothyronine
D. Somatotropic hormone
E. Thyrocalcitonin
62. A patient is followed up in an endocrinological dispensary on account of hyperthyreosis.

Weight loss, tachycardia, finger tremor are accompanied by hypoxia symptoms – headache,
fatigue, eye flicker. What mechanism of thyroid hormones action underlies the development of
hypoxia?
A. Disjunction, oxydation and phosphorilation
B. Inhibition of respiratory ferment synthesis
C. Competitive inhibition of respiratory ferments
D. Intensification of respiratory ferment synthesis
E. Specific binding of active centres of respiratory ferments
63. A 45-year-old woman has been diagnosed with endemic goiter. What mechanism has
caused hyperplasia of thyroid gland in this patient?
A. Increased thyrotropin production
B. Increased thyroxine production
C. Increased catecholamine production
D. Increased hydration of derma and hypodermic cellulose
E. Increased iodine absorption
64. A patient from Prykarpattia (at the foot of the Carpathian mountains) with endemic goiter
consulted a doctor about suppuration of gingival angles and loosening of teeth. What is a major
factor of periodontitis development in this case?
A. Endocrine disorders
B. Hypersalivation
C. Violation of swallowing
D. Stress effects
E. Malnutrition
65. A 29-year-old female patient has moon face, upper body obesity, striae on her anterior
abdominal wall, hirsutism; urine shows an increased rate of 17-oxy ketosteroids. What disease are
these presentations typical for?
A. Itsenko-Cushing syndrome
B. Secondary aldosteronism
C. Primary aldosteronism
D. Conn’s syndrome
E. Pheochromocytoma
66. A 44 year old woman complains of general weakness, heart pain, significant increase of
body weight. Objectively: moon face, hirsutism, AP is 165/100 mm Hg, height – 164 cm, weight
– 103 kg; the fat is mostly accumulated on her neck, thoracic girdle, belly. What is the main
pathogenetic mechanism of obesity?
A. Increased production of glucocorticoids
B. Reduced production of thyroid hormones
C. Increased mineralocorticoid production
D. Increased insulin production
E. Reduced glucagon production
67. To prevent the transplant rejection after organ transplantation it is required to administer
hormonotherapy for the purpose of immunosuppression. What hormones are used for this purpose?
A. Glucocorticoids
B. Mineralocorticoids
C. Sexual hormones
D. Catecholamines
E. Thyroid
68. A 41-year-old male patient has a history of recurrent attacks of heartbeats (paroxysms),
profuse sweating, headaches. Examination revealed hypertension, hyperglycemia, increased basal
metabolic rate, and tachycardia. These clinical presentations are typical for the following adrenal
pathology:
A. Hyperfunction of the medulla
B. Hypofunction of the medulla
C. Hyperfunction of the adrenal cortex
D. Hypofunction of the adrenal cortex
E. Primary aldosteronism
69. A patient suffering from pheochromocytoma complains of thirst, dry mouth, hunger.
Blood test for sugar revealed hyperglycemia. What type of hyperglycemia is it?
A. Adrenal
B. Hypercorticoid
C. Alimentary
D. Somatotropic
E. Hypoinsulinemic
70. A girl is diagnosed with adrenogenital syndrome (pseudohermaphroditism). This
pathology was caused by hypersecretion of the following adrenal hormone:
A. Androgen
B. Estrogen
C. Aldosterone
D. Cortisol
E. Adrenalin
71. A female patient presents with endocrine dysfunction of follicular cells of the ovarian
follicles resulting from an inflammation. The synthesis of the following hormone will be inhibited:
A. Estrogen
B. Lutropin
C. Follistatine
D. Follicle stimulating hormone
E. Progesterone
72. 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:
A. Somatotropin
B. Glucagon
C. Thyroxine
D. Cortisol
E. Insulin
73. A 43-year-old female complains of weight loss, hyperhidrosis, low-grade fever, increased
irritability. She has been found to have hyperfunction of the sympathetic- adrenal system and basal
metabolism. These disorders can be caused by hypersecretion of the following hormone:
A. Thyroxine
B. Insulin
C. Corticotropin
D. Somatotropin
E. Aldosterone
74. A patient with hypoparathyreosis has multiple carious lesions of teeth. This pathology is caused
by insufficiency of the following hormone:
A. Calcitonin
B. Triiodothyronine
C. Somatotropin
D. Thyroid-stimulating hormone
E. Thyroxin
75. A patient with pituitary tumor complains of increased daily diuresis (polyuria). Glucose
concentration in blood plasma equals 4,8 mmol/1. What hormone can be the cause of this if its
secretion is disturbed?
A. Vasopressin
B. Natriuretic hormone
C. Insulin
D. Angiotensin I
E. Aldosterone
76. A 49-year-old patient was found to have a disproportionate enlargement of hands, feet, nose,
ears, superciliary arches and cheek bones. Blood test revealed hyperglycemia, impaired glucose
tolerance. What is the most likely cause of this pathology development?
A. Insulin hyposecretion
B. Hypersecretion of growth hormone
C. Posterior pituitary hormone hypersecretion
D. Glucocorticoid hypersecretion
E. Vasopressin hyposecretion
77. A patient with signs of osteoporosis and urolithiasis has been admitted to an endocri-nology
department. Blood test revealed hypercalcemia and hypophosphatemia. The changes are
associated with abnormal ',synthesis of the following hormone:
A. Calcitriol
B. Parathyroid hormone
C. Calcitonin
D. Cortisol
E. Aldosterone
78. A patient caught a cold after which there appeared facial expression disorder. He cannot
close his eyes, raise his eyebrows, bare his teeth. What nerve is damaged?
A. Facial
B. Vagus
C. Trigeminus
D. Glossopharyngeal
E. Infraorbital
79. A 68-year-old woman can’t move by the upper and lower right extremities due to insult.
Muscle tone of these extremities and reflexes are increased. There are pathological reflexes. What
form of the paralysis is it?
A. Hemiplegia
B. Paraplegia
C. Tetraplegia
D. Monoplegia
E. Dissociation
80. After a car accident a patient has been diagnosed with a fracture of spine. He is unable
to move his lower extremities. This form of motor disorder is called:
A. Paraplegia
B. Paralysis
C. Paresis
D. Hemiplegia
E. Quadriplegia
81. After poisoning with an unknown drug a 37 year old patient has stereotypical face muscle
contractions that imitate blinking and squinting. What form of motor function disorder of nervous
system is it?
A. Hyperkinesia
B. Hypokinesia
C. Akinesia
D. Ataxy
E. –
82. An experimental rat with extremity paralysis has no tendon and cutaneous reflexes,
muscle tone is decreased, but muscles of the affected extremity maintain their ability to react with
excitation to the direct action of continuous current. What type of paralysis is it?
A. Flaccid peripheral
B. Flaccid central
C. Spastic peripheral
D. Spastic central
E. Extrapyramidal
83. A patient complaining of pain in the left shoulder-blade region has been diagnosed with
myocardial infarction. What kind of pain does the patient have?
A. Radiating
B. Visceral
C. Phantom
D. Protopathic
E. Epicritic
84. After the traumatic tooth extraction a patient is complaining of acute, dull, poorly-
localized pain in gingiva, body temperature rise up to 37,5o C. The patient has been diagnosed with
alveolitis. Specify the kind of pain in this patient:
A. Protopathic
B. Epicritic
C. Visceral
D. Heterotopic
E. Phantom
85. A patient got a gunshot wound of hip which damaged the sciatic nerve. Any impact on
the affected limb causes severe, excruciating pain. What mechanism of pain is most likely in this
case?
A. Causalgic
B. Reflex
C. Phantom
D. Endorphin hypofunction
E. Enkephalin hypofunction
86. Four months ago a 43 year old patient had a traumatic amputation of his lower extremity.
Now he complains of sensing the amputated extremity and having constantly grave, sometimes
unbearable pain in it. What type of pain does he have?
A. Phantom
B. Causalgia
C. Neuralgia
D. Thalamic
E. Reflex
87. A patient complains of toothache. On examination he has been diagnosed with pulpitis.
Which factor played a main pathogenic role in the development of pain syndrome in this case?
A. Increased intratissular pressure in the dental pulp
B. Interleukin action
C. Vasospasm
D. Inadequate stimulation of a mandibular nerve branch
E. Activation of one of the components of the complement system
88. A 28 year old man had a gunshot wound of shin that resulted in an ulcer from the side of
the injury. What is the main factor of neurodystrophy pathogenesis in this case?
A. Traumatization of peripheral nerve
B. Psychical stress
C. Microcirculation disturbance
D. Infection
E. Tissue damage
89. A patient who takes a blocker of membrane cytoreceptors of efferent conductor synapses
of autonomic nervous system complains about dry mouth. What receptors are blocked?
A. Muscarinic cholinoreceptors
B. Nicotinic cholinoreceptors
C. H2-receptors
D. alpha-adrenoreceptors
E. beta-adrenoreceptors
90. A patient with hypertension has 141, developed headache, tinnitus, vomiting, high BP up to
220/160 mm Hg. On examination: facial asymmetry on the right, volitional mobility is absent,
increased tendon reflexes ng e and muscle tone of extremities on the ri-ght. What motor disorder
of nervous system occurred in this case?
A. Monoplegia
B. Hyperkinesis
C. Paraplegia
D. Hemiplegia
E. Tetraplagia
91. After a long-lasting and grave illness the blood pressure of a patient fell up to 60/40 mm;
he has tachycardia, dyspnea, black-out. How can this state be defined?
A. Preagony
B. Agony
C. Shock
D. Apparent death
E. –
92. As a result of a trauma a patient has developed traumatic shock. The patient is fussy,
talkative, pale. AP is 140/90 mm Hg, Ps is 120 bpm. This condition is consistent with the following
shock phase:
A. Erectile
B. Latent period
C. Terminal
D. Torpid
E. –
93. A 45 year old patient was taken to the hospital by an emergency team with serious cranial
trauma in shock condition. Objectively: unconscious, skin is pale, body t o – 35o С, low muscular
tonus, reflexes are absent, pulse is rapid and weak, AP – 50/30 mm Hg. What clinical shock stage
is it?
A. Terminal stage
B. Erectile stage
C. Excitement stage
D. Inhibition stage
E. Torpid stage
94. 15 minutes after a car accident examination of a 35 year old man revealed massive injury
of lower extremities without serious external loos of blood. The victim is in excited state. What
component of pathogenesis of traumatic shock is basic and requires urgent correction?
A. Pain
B. Acute renal insufficiency
C. Intoxication
D. Cardiac function disorder
E. Internal loss of plasma
95. A 26 year old man is in the torpid shock phase as a result of a car accident. In blood:
3,2*109/l. What is the leading mechanism of leukopenia development?
A. Redistribution of leukocytes in bloodstream
B. Leukopoiesis inhibition
C. Disturbed going out of mature leukocytes from the marrow into the blood
D. Lysis of leukocytes in the blood-forming organs
E. Intensified elimination of leukocytes from the organism
96. Two days after myocardial infarction a patient had a sudden systolic pressure decrease
up to 60 mm, tachycardia up to 140/min, dyspnea; the patient lost consciousness. What mechanism
is principal for the shock pathogenesis?
A. Decrease of cardiac volume
B. Intoxication
C. Decrease of circulating blood volume
D. Paroxysmal tachycardia
E. Anaphylactic reaction
97. A patient who suffers from acute myocarditis has clinical signs of cardiogenic shock.
What of the under-mentioned pathogenetic mechanisms plays the main part in shock development?
A. Disturbance of pumping ability of heart
B. Depositing of blood in organs
C. Reduction of diastolic flow to the heart
D. Decrease of vascular tone
E. Increase of peripheral vascular resistance
98. A patient with an acute myocarditis has the clinic presentations of cardiogenic shock.
What pathogenetic mechanism plays the main part in shock development?
A. Disorder of pumping ability of heart
B. Depositing of blood in veins
C. Decrease of diastolic flow to the heart
D. Decrease of vascular tone
E. Increase of vascular tone
99. Injection of an anaesthetic before the tooth extraction resulted in development of

anaphylactic shock accompanied by oliguria. What pathogenetic mechanism caused a decrease in
diuresis in this case?
A. Decrease in hydrostatic pressure in the renal corpuscle capillaries
B. Increase in hydrostatic pressure in the Bowman’s capsule
C. Damage of glomerular filter
D. Increase in oncotic pressure of blood plasma
E. Increase in vasopressin secretion
100. After the transfusion of the concentrated red blood cells the patient developed
posttransfusion shock. What is the leading mechanism of acute renal failure in this case?
B. Tubular secretion disorder
C. Impairment of the renal incretory function
101. A patient has been diagnosed with influenza. His condition became drastically worse
after taking antipyretic drugs. His consciousness is confused, AP is 80/50 mm Hg, Ps is 140/m,
body temperature dropped down to 35,8o C. What complication developed in this patient?
A. Collapse
B. Hyperthermia
C. Hypovolemia
D. Acidosis
E. Alkalosis
102. In the third period of fever a patient had a critical body temperature drop accompanied
by tachycardia and arterial pressure drop down to 80/60 mm Hg. Specify a type of collapse
developed as a result of these changes:
A. Infectious-and-toxical collapse
B. Cardiogenic
C. Haemorrhagic
D. Pancreatic
E. Orthostatic
103. A 27-year-old patient with injury to the neck has lost approximately 30% of the blood
volume. The patient’s condition is severe: blood pressure is 60/40 mm Hg, heart rate is 140/min.,
respiratory rate is 30/min., conscious. Characterize the condition of the patient’s circulatory
system:
A. Coma
B. Hypovolemic shock
C. Cardiogenic shock
D. Arterial hypertension
E. Collapse
104. After a road accident a victim has tachycardia, arterial blood pressure 130/90 mm Hg,
tachypnoe, the skin is pale and dry, excitation of central nervous system is observed. What shock
stage is the patient most likely in ?
A. Terminal
B. Preshock
C. Agony
D. Erectile
E. Torpid
105. Patient with diabetes didn’t get insulin injection in time that caused hyperglycemic
coma (glucose in the blood 50 mmol/L). What mechanism is prevalent in the development of the
coma?
A. Hyperosmia
B. Hypokaliemia
C. Hypoxia
D. Hyponatremia
E. Acidosis
106. A 12-year-old teenager has significantly put off weight within 3 months; glucose
concentration rose up to 50 millimole/l. He fell into a coma. What is the main mechanism of its
development?
A. Hyperosmolar
B. Hypoglycemic
C. Ketonemic
D. Lactacidemic
E. Hypoxic
107. An experimental rat got intra-abdominal injection of 10 ml of 40% glucose solution. 60
minutes later the rat passed into a comatose state as a result of dehydratation. What is the
mechanism of development of this state?
A. Rise of osmotic pressure of extracellular fluid
B. Rise of oncotic pressure of extracellular fluid
C. Reduction of vasopressin secretion
D. Loss of salts and water
E. Acid-base disbalance
108. An unconscious patient had been delivered to a hospital by the ambulance. Objectively:
absent reflexes, occasional convulsions, irregular breathing. After a laboratory examination he was
diagnosed with hepatic coma. What metabolite accumulation is essential for the development of
the central nervous system disorders?
A. Ammonia
B. Urea
C. Glutamine
D. Bilirubin
E. Histamine
109. A 62-year-old patient has been hospitalized due to massive cerebral hemorrhage. Blood
pressure is 70/30 mm Hg, heart rate is 120/min., respiratory rate is 4/min., unconscious, no
response to external stimuli. Such condition can be determined as:
A. Collapse
B. Coma
C. Shock
D. Agony
E. Stress
110. A patient with jaundice has high total bilirubin that is mainly indirect (unconjugated), high
concentration of stercobilin in the feces and urine. The level of direct (conjugated) bilirubin in the
blood plasma is normal.
What type of jaundice can be suspected ?
A. Gilbert’s disease
B. Parenchymal (hepatic)
C. Neonatal
D. Mechanical
E. Hemolytic
111. A patient complaining of pain in the left shoulder-blade region has been diagnosed with
miocardial infarction. What kind of pain does the patient have?
A. Phantom
B. Visceral
C. Protopathic
D. Radiating
E. Epicritic
112. On examination the patient presents with hirsutism, moon-shaped face, stretch
marks on the abdomen. BP is 190\100 mm Hg, blood glucose is 17.6 mmol\l.
What pathology is such clinical presentation characteristic of?
A. Hypothyroidism
B. Hyperthyroidism
C. Adrenocortical hyperfunction
D. Hyperfunction of the insular apparatus
E. Gonadal hypofunction
113. A 38—year—old man, who has been suffering from systemic lupus erythematosus for 3
years, developed diffuse renal lesions accompanied by massive edemas, marked proteinuria,
hyperlipidemia, and dysproteinemia. What is the most likely mechanism of proteinuria develoment
in this case?
A. Morbid affection of the urinary tracts

B. Ischemic damage to the tubules
C. Autoimmune damage to the nephrons
D. Inflammatory damage to the nephrons
E. Increased blood proteins
114. A 50-year-old inpatient during examination presents with glucosuria and blood glucose of
3,0 mmol/l, which are the most likely to be caused by:
A. Renal disorder
B. Myxedema
C. Pellagra
115. A 46-year-old woman suffering from cholelithiasis developed jaundice. Her urine became
dark yellow, while feces are light – color. What substance will be the most increased in
concentration in the blood serum in this case?
A. Conjugated bflirubin
B. Mesobilirubin
C. Urobilinogen
D. Biliverdine
E. Unconjugated bih’rubin
116. A 38-year-old man, who has been suffering from systemic lupus erythematosus for 3 years,
developed diffuse renal lesions accompanied by massive edemas, marked proteinuria,
hyperlipidemia, and dysproteinemia. What is the most likely mechanism of proteinuria develoment
in this case?
A. Autoimmune damage to the nephrons
B. Ischemic damage to the tubules
C. Morbid affection of the urinary tracts
D. Inflammatory damage to the nephrons
E. Increased blood proteins
117. A patient suffers from posttraumatic hemorrhage that resulted in development of hemorrhagic
shock. What volume of circulating blood was lost by the patient?
A. 25-40%
B. 40-50%
C. 50-75%
D. 12-25%
E. 3-20%
118. On examination the patient presents with hirsutism, moon-shaped face, stretch marks on the
abdomen. BP is 190/100 mm Hg, blood glucose is 17.6 mmol/L. What pathology is such clinical
presentation characteristic of?
A. Adrenocortical hyperfunction
B. Gonadal hypofunction
C. Hyperthyroidism
D. Hyperfunction of the insular apparatus
E. Hypothyroidism
119. A victim of a traffic accident was received by the intensive care unit. The patient is in a grave
condition that can be characterized as a severe pathologic process that leads to exhaustion of vital
functions and puts the patient into the marginal state between life and death due to critical
reduction of capillary circulation in the affected organs. The patient is in the state of:
A. Shock
B. Collapse
C. Preagony
D. Coma
E. Agony
120. During removal of the hyperplastic thyroid gland of a 47-year-old woman, the parathyroid
gland was damaged. One month after the surgery the patient developed signs of
hypoparathyroidism: frequent convulsions, hyperreflexia, laryngospasm. What is the most likely
cause of the patient’s condition?
A. Hypocalcemia
B. Hyponatremia
C. Hyperchlorhydria
D. Hypophosphatemia
E. Hyperkalemia
121. On clinical examination a woman presents with excessive sweating, tachycardia, loss of
weight, and tremor. What endocrine pathology can cause these sings?
A. Hyperthyroidism
B. Hypergonadism
C. Hypoaldosteronism
D. Hypothyroidism
E. Hypogonadism
122. A patient with Cushing syndrome presents with persistent hyperglycemia and glycosuria.
This patient is likely to have increased production and secretion of the following hormone:
A. Glucagon
B. Aldosteron
C. Adrenalin
D. Cortisol
E. Thyroxine
123. A 50-year-old man, who has been suffering from chronic hepatic failure for years, developed
ascites. What is the main mechanism of development of this new disorder in the patient?
A. Decreased hepatic synthesis of albumins and globulins
B. Increased pressure in the portal venous system
C. Increased oncotic blood pressure
D. Appearance of necrotoxin substances in blood
E. Increased blood levels of low density and very low density lipoproteins
124. The doctor started the absence of respiration and cardiac activity in a traffic accident victim.
This condition lasts for 1 minute already. This clinical presentation corresponds with the following
terminal state:
A. Traumatic shock, torpid phase
B. Clinical death
C. Agony
D. Traumatic shock, erectile phase
E. Preagony

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Coronarogenic injury of the myocardium. Coronary vessels insufficiency. Ischemic heart

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